Depressive symptoms and suicidal behavior after first-episode psychosis: A comprehensive systematic review. (July 2017)

• Record Type: Journal Article
• Authors: Coentre, Ricardo; Talina, Miguel Cotrim; Góis, Carlos; Figueira, Maria Luísa
• Is Part Of: Psychiatry research. Volume 253(2017)
• Page Start: 240
• Page End: 248
• Publication Date: 2017-07
• Subjects: Suicide -- Schizophrenia -- Duration of untreated psychosis -- Suicide attempts -- First-episode psychosis; Psychiatry -- Periodicals; Psychiatry -- periodicals; Psychiatrie -- Périodiques; 616.89
• DOI: 10.1016/j.psychres.2017.04.010
• Languages: English
• ISSNs: 0165-1781

Abstract

Abstract: Depressive symptoms and suicidal behavior are common among patients that suffered a first-episode psychosis. We searched Web of Knowledge SM and Pubmed® for English and Portuguese original articles investigating prevalence of depressive symptoms and/or suicidal behavior and associated factors after first-episode psychosis. We included 19 studies from 12 countries, 7 studied depressive symptoms and 12 suicidal behavior. The findings confirm that depressive symptoms and suicidal behavior have high rates in the years after first-episode psychosis. Factors identified as being associated with depressive symptoms after first-episode psychosis were anomalies of psychosocial development, poor premorbid childhood adjustment, greater insight, loss, shame, low level of continuing positive symptoms and longer duration of untreated psychosis. Suicidal behavior was associated with previous suicide attempt, sexual abuse, comorbid polysubstance use, lower baseline functioning, longer time in treatment, recent negative events, older patients, longer duration of untreated psychosis, higher positive and negative psychotic symptoms, family history of severe mental disorder, substance use, depressive symptoms and cannabis use. Data also indicate that treatment and early intervention programs reduce depressive symptoms and suicidal behavior after first-episode psychosis. Future research should overcome some methodological discrepancies that exist between studies and limit generalization of current findings. Highlights: Depressive symptoms and suicidal behavior are common after first-episode psychosis. We reviewed the prevalence and associated factors of depression and suicidal behavior after first-episode psychosis. High rates of depressive symptoms and suicidal behavior after first-episode psychosis were found. Development of preventive interventions to reduce depression and suicidal behavior after first-episode psychosis are needed. Future research should overcome some methodological limitations of current studies.