Trajectories of suicidal ideation after first-episode psychosis: a growth mixture modeling approach
Por:
Salagre, E, Grande, I, Jimenez, E, Mezquida, G, Cuesta, MJ, Llorente, C, Amoretti, S, Lobo, A, Gonzalez-Pinto, A, Carballo, JJ, Corripio, I, Verdolini, N, Castro-Fornieles, J, Legido, T, Carvalho, AF, Vieta, E, Bernardo, M, PEPs Grp
Publicada:
1 may 2021
Ahead of Print:
1 feb 2021
Resumen:
Objective The period immediately after the onset of first-episode psychosis (FEP) may present with high risk for suicidal ideation (SI) and attempts, although this risk may differ among patients. Thus, we aimed to identify trajectories of SI in a 2-years follow-up FEP cohort and to assess baseline predictors and clinical/functional evolution for each trajectory of SI.
Methods We included 334 FEP participants with data on SI. Growth mixture modeling was used to identify trajectories of SI. Putative sociodemographic, clinical, and cognitive predictors of the distinct trajectories were examined using multinomial logistic regression.
Results We identified three distinct trajectories: Non-SI trajectory (85.53% sample), Improving SI trajectory (9.58%), and Worsening SI trajectory (6.89%). Multinomial logistic regression model revealed that greater baseline pessimistic thoughts, anhedonia, and worse perceived family environment were associated with higher baseline SI followed by an Improving trajectory. Older age, longer duration of untreated psychosis, and reduced sleep predicted Worsening SI trajectory. Regarding clinical/functional evolution, individuals within the Improving SI trajectory displayed moderate depression at baseline which ameliorated during the study period, while the Worsening SI subgroup exhibited persistent mild depressive symptoms and greater functional impairment at follow-up assessments.
Conclusion Our findings delineated three distinct trajectories of SI among participants with FEP, one experiencing no SI, another in which SI might depend on acute depressive symptomatology, and a last subset where SI might be associated with mild but persistent clinical and functional impairments. These data provide insights for the early identification and tailored treatment of suicide in this at-risk population.
Filiaciones:
Salagre, E:
Univ Barcelona, Hosp Clin, Bipolar & Depress Disorders Unit, IDIBAPS,CIBERSAM, Barcelona 08036, Catalonia, Spain
Grande, I:
Univ Barcelona, Hosp Clin, Bipolar & Depress Disorders Unit, IDIBAPS,CIBERSAM, Barcelona 08036, Catalonia, Spain
Jimenez, E:
Univ Barcelona, Hosp Clin, Bipolar & Depress Disorders Unit, IDIBAPS,CIBERSAM, Barcelona 08036, Catalonia, Spain
Mezquida, G:
Hosp Clin Barcelona, Neurosci Inst, Barcelona Clin Schizophrenia Unit, Barcelona, Spain
Biomed Res Networking Ctr Mental Hlth Network CIB, Madrid, Spain
Complejo Hosp Navarra, Inst Invest Sanitarias Navarra IdiSNa, Dept Psychiat, Pamplona, Spain
Cuesta, MJ:
Complejo Hosp Navarra, Inst Invest Sanitarias Navarra IdiSNa, Dept Psychiat, Pamplona, Spain
Llorente, C:
Univ Complutense, Hosp Gen Univ Gregorio Maranon, CIBERSAM,IiSGM,Sch Med, Dept Child & Adolescent Psychiat,Inst Psychiat &, Madrid, Spain
Amoretti, S:
Hosp Clin Barcelona, Neurosci Inst, Barcelona Clin Schizophrenia Unit, Barcelona, Spain
Biomed Res Networking Ctr Mental Hlth Network CIB, Madrid, Spain
August Pi i Sunyer Biomed Res Inst IDIBAPS, Barcelona, Spain
Lobo, A:
Univ Zaragoza, Inst Invest Sanitaria Aragon IIS Aragon, Dept Med & Psychiat, Zaragoza, Spain
Gonzalez-Pinto, A:
Univ Basque Country, Hosp Univ Alava, BIOARABA Hlth Res Inst, Dept Psychiat, Vitoria, Spain
Carballo, JJ:
Univ Complutense, Hosp Gen Univ Gregorio Maranon, CIBERSAM,IiSGM,Sch Med, Dept Child & Adolescent Psychiat,Inst Psychiat &, Madrid, Spain
Corripio, I:
Univ Autonoma Barcelona UAB, Dept Psychiat, Biomed Res Inst St Pau IIB St Pau, Hosp St Pau, Barcelona, Spain
Verdolini, N:
Univ Barcelona, Hosp Clin, Bipolar & Depress Disorders Unit, IDIBAPS,CIBERSAM, Barcelona 08036, Catalonia, Spain
Castro-Fornieles, J:
Univ Barcelona, Hosp Clin Barcelona, Clin Inst Neurosci,IDIBAPS, Dept Child & Adolescent Psychiat & Psychol,CIBERS, 2017SGR881, Barcelona, Spain
Legido, T:
Hosp del Mar Med Res Inst, Neurosci Grp, Barcelona, Spain
Carvalho, AF:
Univ Toronto, Ctr Addict & Mental Hlth, Dept Psychiat, Toronto, ON, Canada
Deakin Univ, IMPACT Innovat Mental & Phys Hlth & Clin Treatmen, Sch Med, Barwon Hlth, Geelong, Vic, Australia
Vieta, E:
Univ Barcelona, Hosp Clin, Bipolar & Depress Disorders Unit, IDIBAPS,CIBERSAM, Barcelona 08036, Catalonia, Spain
Bernardo, M:
Hosp Clin Barcelona, Neurosci Inst, Barcelona Clin Schizophrenia Unit, Barcelona, Spain
Biomed Res Networking Ctr Mental Hlth Network CIB, Madrid, Spain
August Pi i Sunyer Biomed Res Inst IDIBAPS, Barcelona, Spain
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