One out of ten Young people who suffer from a psychotic break make a suicide attempt in the following two years
11% of young people between 18 and 35 who suffered a first psychotic break attempted
suicide in the following two years
Research conducted by the Mental Health Research Group of the Hospital del Mar Medical Research Institute (IMIM-Hospital del Mar) and the Mental Health CIBER (CIBERSAM) has made possible to establish the factors that make these people to have a higher risk of suicide than other patients with this disorder. The study is published in the Psychiatry Research journal and is one of the most extensive of its kind carried out in Spain.
This research has followed for over two years nearly 300 patients seen in the Study and Treatment of Psychotic Episodes (ETEP) program of Hospital del Mar between 2013 and 2020. They range between 18 and 35, with an average age of 25 years. More than 60% of them are men, but no gender differences were detected. In thirty cases, they attempted suicide on one or more occasion during the time the study was being carried out. Almost half of the attempts occurred between the onset of psychotic symptoms and the start of treatment, i.e., alongside the untreated psychosis. There was also an increase between six months and one year after the first outbreak. This fact is probably a consequence of the disruption of the affected people’s expectations of a fast recovery and return to normal life.
Dr. Anna Mané, coordinator of the research and a model of the emergency and acute process of the Psychiatry Service and the Emerging Psychosis Care Program (PAE-TPI) of Hospital del Mar, highlights the relevance of early detection to reduce the time in which patients begin to have symptoms and receive treatment. To achieve this, "greater knowledge of psychosis is needed, also among family physicians, health workers and other agents involved, such as schools, which would help in early detection, improving prognosis and reducing suicide attempts and other risk situations". To this mean, Dr. Alba Toll, lead author of the research, post-doctoral researcher at IMIM-Hospital del Mar and assistant physician of the Psychiatry Department, points out that "it has been seen that this period of time is very important, because the longer the time without treatment with psychotic symptoms, even if they are mild, the worse the evolution of these patients will be and the more difficult it will be for them to return to regular life. Hence the importance of first-episode programs, to be able to detect them as early as possible and to be able to treat them".
This research identifies as the main risk factors for suicide attempts, having made one before the onset of psychotic symptoms, as well as suffering strong feelings of guilt and low functionality in daily life, with a low quality of life. Warning signs that lead Dr. Mané to warn people that "individualized treatment should be applied to patients who have made previous attempts and have depressive symptoms and feelings of guilt".
Original paper: Toll A, Pechuan E, Bergé D, Legido T, Martínez-Sadurní L, El-Abidi K, Pérez-Solà V, Mané A. Factors associated with suicide attempts in first-episode psychosis during the first two years after onset. Psychiatry Res. 2023 Apr 28;325:115232. doi: 10.1016/j.psychres.2023.115232. Epub ahead of print. PMID: 37146463.