The suicide behavior and deliberate self harm pattern of psychotic patients over 10 years in Hong Kong

Abstract

Background Early interventions (EI) for psychosis are predicted to have an effect in reducing suicidal attempts and self harms for first episode psychosis (FEP) patients. However there is little evidence to reveal that early intervention has a long term effect in reducing suicidal behaviors. Also, the longitudinal patterns of suicidal behavior of patients under EI and standard care (SC) programme were remained unclear. Therefore, this study was performed to explore the longitudinal pattern of suicidal behaviors for EI and SC patients. The long term effect of EI in reducing suicidal attempts and self harms and possible predictors for suicide were also explored and analysed. Method A secondary analysis was performed with data retrieved from medical data in different hospitals. The data are matched up for SC patients and EI patients based on their demographic information. Data related to suicidal behaviors are collected. Longitudinal patterns of suicidal behaviors were analysis with generalized linear model (GENLIN) and descriptive analysis. Univariate regression was also performed to investigate predictors for suicide. Results EI has a significant effect in reducing the total number of suicidal attempts (X^2=5.779, p=0.016) and deliberate self harm (X2=7.817, 0.005) over 10 years but no effect on suicidal attempts in the first three year when effect was expected. However, data indicated EI has an effect of reducing the number of complete suicide. Patients do not receive EI is a significant predictor for increase in the suicidal attempts and younger age is a predictor for latter deliberate self harm behaviors. Conclusion The result demonstrated that EI has a long term effect in reducing suicidal behavior rather only short term and non-lasting effect as suggested by other researches. However, EI treatment might have a short term negative effect on suicidal ideations as suggested by the increase of suicidal attempts in the second and third years. EI services do not only improve in symptoms and quality of life but a long term effects in reducing the number suicidal behaviors. Although, there is a possible negative effect on suicidal attempts, it might be beneficial if EI programme can be apply to all psychotic patients.