Lifetime suicidal thoughts, attempts, and lethality of attempts as major outcome domains of psychotic disorders: a 21-year prospective cohort study after a first-episode psychosis

Background: Suicidal thoughts and behaviors (STBs) are a major concern in people with psychotic disorders. There is a need to examine their prevalence over long-term follow-up after first-episode psychosis (FEP) and determine their early predictors. Methods: Of 510 participants with FEP evaluated on...

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Authors: Peralta, Víctor, Moreno-Izco, Lucía, García de Jalón, Elena, Sánchez Torres, Ana M., Peralta, David, Janda, Lucía, Cuesta, Manuel J., SEGPEPs group, Ansorena, Xabier, Ballesteros, Alejandro, Chato, Julen, Fañanás Saura, Lourdes, Gil-Berrozpe, Gustavo, Giné-Servé, Eloi, Lorente, Ruth, Papiol, Sergi, Ribeiro, María, Rosado, Esther, Rosero, Ángela
Format: article
Status:Published version
Publication Date:2025
Country:España
Institution:Universidad de Barcelona
Repository:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/222624
Online Access:https://hdl.handle.net/2445/222624
Access Level:Open access
Keyword:Conducta suïcida
Psicosi
Suicidal behavior
Psychoses
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spelling Lifetime suicidal thoughts, attempts, and lethality of attempts as major outcome domains of psychotic disorders: a 21-year prospective cohort study after a first-episode psychosisPeralta, VíctorMoreno-Izco, LucíaGarcía de Jalón, ElenaSánchez Torres, Ana M.Peralta, DavidJanda, LucíaCuesta, Manuel J.SEGPEPs groupAnsorena, XabierBallesteros, AlejandroChato, JulenFañanás Saura, LourdesGil-Berrozpe, GustavoGiné-Servé, EloiLorente, RuthPapiol, SergiRibeiro, MaríaRosado, EstherRosero, ÁngelaConducta suïcidaPsicosiSuicidal behaviorPsychosesBackground: Suicidal thoughts and behaviors (STBs) are a major concern in people with psychotic disorders. There is a need to examine their prevalence over long-term follow-up after first-episode psychosis (FEP) and determine their early predictors. Methods: Of 510 participants with FEP evaluated on 26 risk factors for later outcomes, 260 were reassessed after 21 years of follow-up for lifetime ratings of most severe suicidal ideation, number of suicide attempts, and lethality of the most severe attempt. Risk factors and STB outcomes were modeled using hierarchical linear regression analysis. Results: Over the 21-year follow-up period, 62.7% of participants experienced suicidal thoughts, 40.8% attempted suicide, and 18 died of suicide (3.5% case fatality and 20.6% proportionate mortality). Suicidal ideation was independently predicted by parental socioeconomic status, familial load of major depression, neurodevelopmental delay, poor adolescence social networks, and suicidal thoughts/behavior at FEP. The number of suicide attempts was independently predicted by years of follow-up, familial load of major depression, obstetric complications, childhood adversity, and suicidal thoughts/behavior at FEP. Lethality was independently predicted by familial load of major depression, obstetric complications, neurodevelopmental delay, and poor adolescence social networks. The proportion of variance in suicidal ideation, attempts, and lethality explained by the independent predictors was 29.3%, 21.2%, and 18.1%, respectively. Conclusions: STBs are highly prevalent in psychotic disorders and leads to substantial morbidity and mortality. They were predicted by a number of early risk factors, whose clinical recognition should contribute to improved prediction and prevention in people with psychotic disorders.Cambridge University Press (CUP)2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/222624Articles publicats en revistes (Biologia Evolutiva, Ecologia i Ciències Ambientals)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1017/S0033291725000443Psychological Medicine, 2025, vol. 55, p. 1-10https://doi.org/10.1017/S0033291725000443cc by (c) Peralta, V., et al., 2025https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/2226242026-05-27T06:46:51Z
dc.title.none.fl_str_mv Lifetime suicidal thoughts, attempts, and lethality of attempts as major outcome domains of psychotic disorders: a 21-year prospective cohort study after a first-episode psychosis
title Lifetime suicidal thoughts, attempts, and lethality of attempts as major outcome domains of psychotic disorders: a 21-year prospective cohort study after a first-episode psychosis
spellingShingle Lifetime suicidal thoughts, attempts, and lethality of attempts as major outcome domains of psychotic disorders: a 21-year prospective cohort study after a first-episode psychosis
Peralta, Víctor
Conducta suïcida
Psicosi
Suicidal behavior
Psychoses
title_short Lifetime suicidal thoughts, attempts, and lethality of attempts as major outcome domains of psychotic disorders: a 21-year prospective cohort study after a first-episode psychosis
title_full Lifetime suicidal thoughts, attempts, and lethality of attempts as major outcome domains of psychotic disorders: a 21-year prospective cohort study after a first-episode psychosis
title_fullStr Lifetime suicidal thoughts, attempts, and lethality of attempts as major outcome domains of psychotic disorders: a 21-year prospective cohort study after a first-episode psychosis
title_full_unstemmed Lifetime suicidal thoughts, attempts, and lethality of attempts as major outcome domains of psychotic disorders: a 21-year prospective cohort study after a first-episode psychosis
title_sort Lifetime suicidal thoughts, attempts, and lethality of attempts as major outcome domains of psychotic disorders: a 21-year prospective cohort study after a first-episode psychosis
dc.creator.none.fl_str_mv Peralta, Víctor
Moreno-Izco, Lucía
García de Jalón, Elena
Sánchez Torres, Ana M.
Peralta, David
Janda, Lucía
Cuesta, Manuel J.
SEGPEPs group
Ansorena, Xabier
Ballesteros, Alejandro
Chato, Julen
Fañanás Saura, Lourdes
Gil-Berrozpe, Gustavo
Giné-Servé, Eloi
Lorente, Ruth
Papiol, Sergi
Ribeiro, María
Rosado, Esther
Rosero, Ángela
author Peralta, Víctor
author_facet Peralta, Víctor
Moreno-Izco, Lucía
García de Jalón, Elena
Sánchez Torres, Ana M.
Peralta, David
Janda, Lucía
Cuesta, Manuel J.
SEGPEPs group
Ansorena, Xabier
Ballesteros, Alejandro
Chato, Julen
Fañanás Saura, Lourdes
Gil-Berrozpe, Gustavo
Giné-Servé, Eloi
Lorente, Ruth
Papiol, Sergi
Ribeiro, María
Rosado, Esther
Rosero, Ángela
author_role author
author2 Moreno-Izco, Lucía
García de Jalón, Elena
Sánchez Torres, Ana M.
Peralta, David
Janda, Lucía
Cuesta, Manuel J.
SEGPEPs group
Ansorena, Xabier
Ballesteros, Alejandro
Chato, Julen
Fañanás Saura, Lourdes
Gil-Berrozpe, Gustavo
Giné-Servé, Eloi
Lorente, Ruth
Papiol, Sergi
Ribeiro, María
Rosado, Esther
Rosero, Ángela
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Conducta suïcida
Psicosi
Suicidal behavior
Psychoses
topic Conducta suïcida
Psicosi
Suicidal behavior
Psychoses
description Background: Suicidal thoughts and behaviors (STBs) are a major concern in people with psychotic disorders. There is a need to examine their prevalence over long-term follow-up after first-episode psychosis (FEP) and determine their early predictors. Methods: Of 510 participants with FEP evaluated on 26 risk factors for later outcomes, 260 were reassessed after 21 years of follow-up for lifetime ratings of most severe suicidal ideation, number of suicide attempts, and lethality of the most severe attempt. Risk factors and STB outcomes were modeled using hierarchical linear regression analysis. Results: Over the 21-year follow-up period, 62.7% of participants experienced suicidal thoughts, 40.8% attempted suicide, and 18 died of suicide (3.5% case fatality and 20.6% proportionate mortality). Suicidal ideation was independently predicted by parental socioeconomic status, familial load of major depression, neurodevelopmental delay, poor adolescence social networks, and suicidal thoughts/behavior at FEP. The number of suicide attempts was independently predicted by years of follow-up, familial load of major depression, obstetric complications, childhood adversity, and suicidal thoughts/behavior at FEP. Lethality was independently predicted by familial load of major depression, obstetric complications, neurodevelopmental delay, and poor adolescence social networks. The proportion of variance in suicidal ideation, attempts, and lethality explained by the independent predictors was 29.3%, 21.2%, and 18.1%, respectively. Conclusions: STBs are highly prevalent in psychotic disorders and leads to substantial morbidity and mortality. They were predicted by a number of early risk factors, whose clinical recognition should contribute to improved prediction and prevention in people with psychotic disorders.
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/222624
url https://hdl.handle.net/2445/222624
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1017/S0033291725000443
Psychological Medicine, 2025, vol. 55, p. 1-10
https://doi.org/10.1017/S0033291725000443
dc.rights.none.fl_str_mv cc by (c) Peralta, V., et al., 2025
https://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by (c) Peralta, V., et al., 2025
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Cambridge University Press (CUP)
publisher.none.fl_str_mv Cambridge University Press (CUP)
dc.source.none.fl_str_mv Articles publicats en revistes (Biologia Evolutiva, Ecologia i Ciències Ambientals)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,198674

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