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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, often referred to as the first episode of psychosis, is known to be a period with a greatly increased incidence of self-harm and violence to others.2 A recent meta-analysis of existing studies of self-harm in early psychosis found that 18.4% of first-episode patients had self-harmed or attempted suicide prior to initial treatment, while the pooled 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 among child and adolescent patients 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 among adult …
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.