Early Intervention for Schizophrenia Could Lower Suicide Risk

Early intervention (EI) services could help to reduce long-term suicide risk in patients with schizophrenia, according to the results of a recent study.

Suicide rate in patients with schizophrenia is significantly higher than that of the general public. While EI services have been shown to improve short-term outcomes in these patients, little is known about their effects on long-term suicide risk.
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The researchers conducted a historical control study that compared 617 consecutive patients with first-episode schizophrenia-spectrum (FES) disorders who underwent 2-year EI service between July 1, 2001, and June 30, 2003, as well as 617 patients with FES who received standard care between July 1, 1998, and June 30, 2001. The participants were matched individually.

The primary outcome of the study was suicide rate during 12 years, and the association of EI service with suicide rates during years 1 through 3 and years 4 through 12 were explored separately.

Overall, the suicide rates were 7.5% in the standard care group and 4.4% in the EI group. Survival was significantly higher in the EI groujp compared with the standard care group, with the maximum association observed in years 1 through 3. Premorbid occupational impairment, number of relapses, and poor adherence during years 1 through 3 were indicators of suicide in years 4 through 12.

“This study suggests that the EI service may be associated with reductions in the long-term suicide rate,” the researchers concluded. “Suicide at different stages of schizophrenia was associated with unique risk factors, highlighting the importance of a phase-specific service.

—Michael Potts

Reference:

Chan SKW, Chan SWY, Pang HH, et al. Association of an early intervention service for psychosis with suicide rate among patients with first-episode schizophrenia-spectrum disorders. JAMA Psychiatry. 2018;75(5):458-464.