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High rates of suicide attempt in early-onset psychosis are associated with depression, anxiety and previous self-harm
  1. Olav Nielssen1,
  2. Matthew Large2
  1. 1St Vincent's Hospital/University of New South Wales, Sydney, New South Wales, Australia;
  2. 2Prince of Wales Hospital/University of New South Wales, Sydney, New South Wales, Australia
  1. Correspondence to Olav Nielssen, olavn{at}

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What is already known on this topic?

Suicide is a major cause of death among people who develop psychotic illness.1 The period between the onset of symptoms and adequate treatment is known to be a period with a greatly increased incidence of self-harm and violence to others.2 A recent meta-analysis found that 18.4% of first-episode patients had self-harmed or attempted suicide prior to initial treatment, while the proportion of patients who committed acts of self-harm in the period after initial treatment was 11.4%.3 Risk factors associated with self-harm in early psychosis established by meta-analysis include a prior history of self-harm, younger age at onset and initial treatment, depressed mood and a longer duration of untreated psychosis.2

What this paper adds?

  • The rate of attempted suicide after initiation of treatment for first episode psychosis is similar to the rate among older patients.

  • The strength of the associations between severe depression and previous suicide attempts and deliberate self-harm (DSH) might be stronger than …

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  • Competing interests ON is a member of a Lundbeck Advisory Board. ON and ML have received speaker's fees from Astra Zeneca in the past 5 years.