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Risk Factors for Deliberate Self-harm and Suicide Among Adolescents and Young Adults With First-Episode Psychosis.
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- Author(s): Moe AM;Moe AM;Moe AM; Llamocca E; Llamocca E; Llamocca E; Wastler HM; Wastler HM; Steelesmith DL; Steelesmith DL; Brock G; Brock G; Bridge JA; Bridge JA; Bridge JA; Fontanella CA; Fontanella CA
- Source:
Schizophrenia bulletin [Schizophr Bull] 2022 Mar 01; Vol. 48 (2), pp. 414-424.- Publication Type:
Journal Article; Research Support, N.I.H., Extramural- Language:
English - Source:
- Additional Information
- Source: Publisher: Oxford University Press Country of Publication: United States NLM ID: 0236760 Publication Model: Print Cited Medium: Internet ISSN: 1745-1701 (Electronic) Linking ISSN: 05867614 NLM ISO Abbreviation: Schizophr Bull Subsets: MEDLINE
- Publication Information: Publication: 2005- : Cary, NC : Oxford University Press
Original Publication: [Chevy Chase, Md., For sale by the Supt. of Docs., U. S. Govt. Print. Off. Washington] - Subject Terms: Time Factors*; Psychotic Disorders/*complications ; Self-Injurious Behavior/*etiology ; Suicide/*psychology; Adolescent ; Female ; Humans ; Male ; Psychotic Disorders/diagnosis ; Psychotic Disorders/psychology ; Risk Factors ; Self-Injurious Behavior/psychology ; Suicide/statistics & numerical data ; Young Adult
- Abstract: Little is known about the risk factors for deliberate self-harm (DSH) and suicide among adolescents and young adults with first episode psychosis (FEP) and the longitudinal course of DSH following the initial onset of illness. This study identifies risk factors for DSH and suicide death among Medicaid-covered adolescents and young adults with FEP along with the periods of greatest risk for DSH after diagnosis. A retrospective longitudinal cohort analysis was performed using Medicaid claims data merged with death certificate data for 19 422 adolescents and young adults (aged 15-24 years) diagnosed with the onset of FEP between 2010 and 2017. DSH per 1000 person-years and standardized mortality rates for suicide were determined. Hazard ratios of DSH and suicide were estimated by Cox proportional hazard models. During follow-up, 2148 (11.1%) individuals had at least one self-harm event and 22 (0.1%) died by suicide. The hazards of DSH were significantly higher for those with a previous DSH, suicidal ideation, child abuse and neglect, comorbid medical and psychiatric diagnoses, and prior mental health care. The median follow-up time for those who had DSH was 208.0 days (SD: 526.5 days) in adolescents and 108.0 days (SD: 340.0 days) in young adults. Risk of DSH was highest in the first 3 months following FEP. Individuals with FEP are at high risk for self-harm and suicidal behavior, and recognition of who among these individuals and when following illness onset they are at greatest risk may guide more precise clinical recognition and intervention.
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- Contributed Indexing: Keywords: epidemiology; schizophrenia; youth mental health
- Publication Date: Date Created: 20211015 Date Completed: 20220314 Latest Revision: 20221016
- Publication Date: 20240104
- Accession Number: PMC8886578
- Accession Number: 10.1093/schbul/sbab123
- Accession Number: 34651178
- Source:
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