Citation

Harvey SB, Dean K, Morgan C, Walsh E, Demjaha A, Dazzan P, Morgan K, Lloyd T, Fearon P, Jones PB, Murray RM. Br. J. Psychiatry 2008; 192(3): 178-184.

Affiliation

Department of Psychological Medicine, Institute of Psychiatry, King’s College London, Weston Education Centre, 10 Cutcombe Road, London SE5 9RJ, UK. s.harvey@iop.kcl.ac.uk.

Copyright

(Copyright © 2008, Royal College of Psychiatry)

DOI

10.1192/bjp.bp.107.037192

PMID

18310576

Abstract

BACKGROUND: Little is known about self-harm occurring during the period of untreated first-episode psychosis. AIMS: To establish the prevalence, nature, motivation and risk factors for self-harm occurring during the untreated phase of first-episode psychosis. METHOD: As part of the AESOP (Aetiology and Ethnicity in Schizophrenia and Other Psychoses) study, episodes of self-harm were identified among all incident cases of psychosis presenting to services in south-east London and Nottingham over a 2-year period. RESULTS: Of the 496 participants, 56 (11.3%) had engaged in self-harm between the onset of psychotic symptoms and first presentation to services. The independent correlates of self-harm were: male gender, belonging to social class I/II, depression and a prolonged period of untreated psychosis. Increased insight was also associated with risk of self-harm. CONCLUSIONS: Self-harm is common during the pre-treatment phase of first-episode psychosis. A unique set of fixed and malleable risk factors appear to operate in those with first-episode psychosis. Reducing treatment delay and modifying disease attitudes may be key targets for suicide prevention.

Language: en