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First episode psychosis: the depressive symptoms and suicidal behaviour that follow

Published online by Cambridge University Press:  19 July 2023

B. L. B. Mesquita*
Affiliation:
Department of Psychiatry, Hospital de Cascais, Lisbon, Portugal
F. Ribeirinho Soares
Affiliation:
Department of Psychiatry, Hospital de Cascais, Lisbon, Portugal
M. Fraga
Affiliation:
Department of Psychiatry, Hospital de Cascais, Lisbon, Portugal
M. Albuquerque
Affiliation:
Department of Psychiatry, Hospital de Cascais, Lisbon, Portugal
J. Facucho
Affiliation:
Department of Psychiatry, Hospital de Cascais, Lisbon, Portugal
P. Espada
Affiliation:
Department of Psychiatry, Hospital de Cascais, Lisbon, Portugal
S. Paulino
Affiliation:
Department of Psychiatry, Hospital de Cascais, Lisbon, Portugal
P. Cintra
Affiliation:
Department of Psychiatry, Hospital de Cascais, Lisbon, Portugal
*
*Corresponding author.

Abstract

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Introduction

Depressive symptoms and suicidal behaviour are common among patients that suffered a first-episode psychosis. Depressive symptoms could occur in different phases of psychosis, including in post-psychotic period. Depression is a well-known risk factor for suicidal behaviour in psychosis with data showing that occurrence of depression in psychosis have a significant correlation with suicide risk.

Objectives

The purpose of this paper is todo a brief review on the relation of causality that existes between first episode psychosis and depressive symptoms as well as suicidal ideation.

Methods

Brief non-systematic literature review on the topic.

Results

First episode psychosis is not uncommonly followed by depressive symptoms and suicidal thoughts. The rate of suicide attempt in psychotic patients range from 10 to 50%. Individuals with first episode psychosis have a greater risk of suicidal behavior compared with normal population and chronic disorders. In several studies, factors identified as being associated with depressive symptoms after first episode psychosis were anomalies of psychosocial development, poor premorbid childhood adjustment, greater level of continuing positive symptoms and longer duration of untreated psychosis. Suicidal behavior was associated with sexual abuse, previous suicide attempt, comorbid polysubstance use, lower baseline functioning, longer time in treatment, recent negative events, older patients, longer duration of untreated positive and negative psychotic symptoms, family history of severe mental disorder, depressive symptoms and cannabis use. Data also indicate that treatment and early intervention programs reduce depressive symptoms and suicidal behavior after first episode psychosis.

Conclusions

There is convincing evidence that depressive symptoms and suicidal behaviour have high rates after first episode psychosis. The research for treatment of depressive symptoms and/or suicidal behaviour after first-episode psychosis is very limited, therefore this paper aims to bring to light the importance of more studies on the matter.

Disclosure of Interest

None Declared

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association
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