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Review: about one in five people with first-episode psychosis have a history of deliberate self-harm

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Question: How many people with first-episode psychosis have a history of deliberate self-harm (DSH), or commit DSH during the early course of treatment; and what demographic and clinical factors are associated with DSH?

Outcomes: DSH—A history of DSH was defined as a report of DSH at the time of or before initial contact for treatment of psychosis; DSH after treatment was defined as report of DSH in people previously treated for psychosis, regardless of treatment duration.


Design: Systematic review and meta-analysis.

Data sources: MEDLINE, EMBASE and PsycINFO were searched from inception to March 2012, supplemented by hand search of reference lists of included studies and search of the first 1000 hits of Google Scholar.

Study selection and analysis: Studies reporting the association between first-episode psychosis or schizophrenia or early schizophrenia and suicide attempt or DSH. As identified studies did not distinguish between lethal and non-lethal attempts, DSH was the preferred term of the review. Any mental health condition with psychosis as a feature was eligible. Studies of suicidal ideation without attempt were excluded. Demographic and clinical factors potentially …

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