Citation

McGinty J, Sayeed Haque M, Upthegrove R. Schizophr. Res. 2018; 195: 58-66.

Affiliation

University of Birmingham, College of Medical and Dental Sciences, United Kingdom; University of Birmingham, Institute of Mental Health, United Kingdom; Forward Thinking Birmingham, United Kingdom. Electronic address: r.upthegrove@bham.ac.uk.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.schres.2017.09.040

PMID

28982553

Abstract

BACKGROUND: Evidence suggests first episode psychosis (FEP) is associated with suicide, and the influence of depression on suicidal behaviour in cross sectional studies is clear. However the influence of depression during FEP on longer-term mortality is not certain. Existing evidence was synthesised to understand the influence of depressive symptoms during FEP on subsequent suicidal behaviour.

METHODS: Medline, Embase, PsycINFO, Cochrane Library, Web of Science, OpenGrey, and NICE Evidence were searched from inception to Jan 25, 2017. Longitudinal observational studies assessing the relationship between depressive symptoms during FEP with a measure of s at a specified follow-up time were included. Summary estimates were extracted. The Downs and Black Instrument was used to appraise study quality. Odds ratio (OR) of suicidal behaviour were calculated using random effects meta-analyses. The study protocol was registered with PROSPERO (CRD42017055881).

RESULTS: Of 4210 articles found, 23 fulfilled eligibility criteria. 13 were included in meta-analysis (n=3002). 428 participants demonstrated suicidal behaviour in the study periods. Odds of suicidal behaviour during follow-up were significantly higher among patients with depressive symptoms during FEP compared to those without (OR=1.59, 95% CI 1.14-2.21; I2=50.0%, p=0.02). Meta-regression demonstrated no evidence of influence of length of follow-up on results.

CONCLUSIONS: Depressive symptoms during FEP are associated with increased longer-term risk of suicidal behaviour. This association should be acknowledged during early management planning. Large-scale clinical trials are needed to identify efficacious management of depression during FEP.

Copyright © 2017 Elsevier B.V. All rights reserved.

Language: en

Keywords

Depression; First episode psychosis; Meta-analysis; Schizophrenia; Suicidal risk