Risk Factors for Deliberate Self-harm and Suicide Among Adolescents and Young Adults With First-Episode Psychosis.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
  • 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:
    • 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.
      (© The Author(s) 2021. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: [email protected].)
    • References:
      Acta Psychiatr Scand. 2013 Jun;127(6):442-54. (PMID: 23298325)
      Am J Public Health. 2001 Jan;91(1):150-3. (PMID: 11189813)
      Schizophr Res. 2010 Jan;116(1):1-8. (PMID: 19864115)
      Psychiatr Serv. 2017 Jul 1;68(7):674-680. (PMID: 28196458)
      Schizophr Res. 2018 Dec;202:347-353. (PMID: 29935885)
      Lancet. 2012 Jun 23;379(9834):2373-82. (PMID: 22726518)
      Am J Psychiatry. 2018 May 1;175(5):443-452. (PMID: 29495897)
      Health Inf Manag. 2020 Jan;49(1):38-46. (PMID: 31272232)
      Risk Manag Healthc Policy. 2018 Aug 30;11:127-138. (PMID: 30214330)
      Am Psychol. 2000 May;55(5):469-80. (PMID: 10842426)
      Lancet. 2012 Dec 15;380(9859):2129-43. (PMID: 23245605)
      J Registry Manag. 2008 Winter;35(4):156-165. (PMID: 25132914)
      Am J Psychiatry. 2011 Dec;168(12):1266-77. (PMID: 22193671)
      Schizophr Res. 2010 Jun;119(1-3):11-7. (PMID: 20399077)
      Schizophr Res. 2020 Aug;222:382-388. (PMID: 32507375)
      Hosp Community Psychiatry. 1992 Jan;43(1):69-71. (PMID: 1544654)
      Psychol Med. 2018 Apr;48(5):765-776. (PMID: 28805179)
      Suicide Life Threat Behav. 2019 Apr;49(2):423-431. (PMID: 29444349)
      Early Interv Psychiatry. 2021 Jun;15(3):624-633. (PMID: 32462776)
      BMJ. 2004 Jul 31;329(7460):261. (PMID: 15213108)
      Schizophr Bull. 2018 Jun 6;44(4):787-797. (PMID: 29036388)
      Schizophr Res. 2009 May;110(1-3):1-23. (PMID: 19328655)
      Br J Psychiatry. 2012 Dec;201(6):435-43. (PMID: 23209089)
      Br J Psychiatry. 2008 Mar;192(3):178-84. (PMID: 18310576)
      J Psychosom Res. 2009 Jun;66(6):477-93. (PMID: 19446707)
      Acta Psychiatr Scand. 1999 Nov;100(5):389-95. (PMID: 10563457)
      JAMA Psychiatry. 2021 Aug 1;78(8):876-885. (PMID: 34037667)
      Early Interv Psychiatry. 2019 Feb;13(1):101-109. (PMID: 28719155)
      J Clin Psychiatry. 2007 Oct;68(10):1574-83. (PMID: 17960975)
      J R Soc Med. 2014 May;107(5):194-204. (PMID: 24526464)
      Schizophr Bull. 2021 Oct 21;47(6):1685-1694. (PMID: 33991091)
      Int J Epidemiol. 2019 Oct 1;48(5):1636-1649. (PMID: 30907424)
      J Psychopharmacol. 2010 Nov;24(4 Suppl):81-90. (PMID: 20923923)
      Schizophr Res. 2011 Jun;129(1):1-11. (PMID: 21530179)
      J Hosp Med. 2018 Nov;13(11):743-751. (PMID: 30484776)
      Acta Psychiatr Scand. 2000 Oct;102(4):303-9. (PMID: 11089732)
      BMJ. 2005 Apr 16;330(7496):891-4. (PMID: 15831877)
      BMC Pediatr. 2014 Aug 08;14:199. (PMID: 25102958)
      Ann N Y Acad Sci. 2001 Apr;932:44-58; discussion 58-60. (PMID: 11411190)
      Psychiatry Res. 2006 Sep 30;144(1):65-72. (PMID: 16887199)
      Suicide Life Threat Behav. 2005 Feb;35(1):50-62. (PMID: 15843323)
      Natl Vital Stat Rep. 2019 Jun;68(6):1-77. (PMID: 32501203)
      Acta Psychiatr Scand. 2001 May;103(5):347-54. (PMID: 11380304)
      Annu Rev Clin Psychol. 2014;10:425-48. (PMID: 24313570)
      Schizophr Bull. 2021 Apr 29;47(3):864-874. (PMID: 33459778)
      Pediatrics. 2018 Apr;141(4):. (PMID: 29555689)
      Emerg Med J. 2011 Dec;28(12):1019-25. (PMID: 21076053)
    • Grant Information:
      UL1 TR002733 United States TR NCATS NIH HHS; KL2 TR002734 United States TR NCATS NIH HHS; R01 MH117594 United States MH NIMH NIH HHS
    • 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