TY  - JOUR
PY  - 2021//
TI  - Suicidality Over the First 5 Years of Psychosis: Does Extending Early Intervention Have Benefits?
JO  - Canadian journal of psychiatry, The
A1  - Iyer, Srividya N.
A1  - Mustafa, Sally S.
A1  - Moro, Laura
A1  - Jarvis, G. Eric
A1  - Joober, Ridha
A1  - Abadi, Sherezad
A1  - Casacalenda, Nicola
A1  - Margolese, Howard C.
A1  - Abdel-Baki, Amal
A1  - Lepage, Martin
A1  - Malla, Ashok
SP  - 468
EP  - 476
VL  - 66
IS  - 5
N2  - OBJECTIVE: We aimed to investigate whether individuals with first-episode psychosis (FEP) receiving extended early intervention (EI) were less likely to experience suicidal ideation and behaviors than those transferred to regular care after 2 years of EI. Another objective was to examine the 5-year course of suicidality in FEP.  METHODS: We conducted a secondary analysis of a randomized controlled trial where 220 patients were randomized after 2 years of EI to receive extended EI or regular care for the subsequent 3 years. Suicidality was rated using the Brief Psychiatric Rating Scale. Linear mixed model analysis was used to study time and group effects on suicidality.  RESULTS: Extended EI and regular care groups did not differ on suicidality. There was a small decrease in suicidality over time, F(7, 1038) = 1.84, P = 0.077, with an immediate sharp decline within a month of treatment, followed by stability over the remaining 5 years. Patients who endorsed suicidality at entry (46.6%) had higher baseline positive, negative, and depressive symptoms. The 5-year course fell in 3 groups: never endorsed suicidality (33.9%), endorsed suicidality at low-risk levels (43.1%), and endorsed high-risk levels (23.0%). The high-risk group had a higher proportion of affective versus nonaffective psychosis diagnosis; higher baseline positive and depressive symptoms; higher 5-year mean depression scores, and fewer weeks of positive symptom remission over the 5-year course.  CONCLUSIONS: The first month of treatment is a critical period for suicide risk in FEP. Although early reductions in suicidality are often maintained, our findings make the case for sustained monitoring for suicide risk management.<p /> <p>Language: en</p>
LA  - en
SN  - 0706-7437
UR  - http://dx.doi.org/10.1177/0706743720961714
ID  - ref1
ER  -