Personality traits, theory of mind and their relationship with multiple suicide attempts in a sample of first episode psychosis patients: One-year follow-up study

BACKGROUND: High rates of suicidal behaviour (SB) have been found in first episode psychosis (FEP) patients. It has been suggested that the presence of multiple suicide attempts (mSA) increases the risk of later SA and the risk of eventual death by suicide. OBJECTIVE: Our main objective was to study the baseline factors associated with the presence of mSA during the first year after FEP. In addition, a second aim was to find out whether there were any differences between single and multiple suicide attempters in the timing of the first SA after FEP. METHOD: A total of 65 FEP patients were evaluated. The presence of SAs were recorded at two different times after FEP. Bivariate and multivariate analyses were performed to explore the relationship between SA with sociodemographic and clinical variables. RESULTS: Multiple linear regression showed that mSA was associated with the presence of increased symptom severity (B?=?0.35; t?=?3.67; p < 0.01) and errors in first-order false-belief task (B?=?0.48; t?=?2.11; p?=?0.04). There were significant differences in the timing of first SA after FEP between multiple and single suicide attempters. CONCLUSIONS: Theory of mind impairments along with more severe symptoms during the first contact with mental health services for psychotic symptoms appeared to be important predictors of mSA. On the other hand, multiple suicide attempters tend to make a first SA after FEP earlier than single suicide attempters. These results could contribute to the implementation of preventive suicidal programs, however they must be confirmed by additional research.Funding: This study was funded by Ministry of Science and Innovation grant ISC PI11/0233

The role of premorbid personality and social cognition in suicidal behaviour in first-episode psychosis: a one-year follow-up study

Background: High suicide attempt (SA) rates have been reported in first-episode psychosis (FEP) patients, particularly during the first year after the illness onset. Despite previous studies establishing several risk factors for suicidal behaviour in FEP, premorbid personality and social cognition have not been sufficiently investigated to date. Objective: To test whether personality traits and social cognition are associated with SAs in FEP over a 12-month follow-up. Method: Sixty-five FEP patients were evaluated at first contact with mental health services. The presence of SAs was recorded at six and twelve months after first presentation. Bivariate and multivariate analyses explored the influence of a range of sociodemographic and clinical variables, including premorbid personality and social cognition-related Theory of Mind (ToM) measures, on SAs. Results: SAs were associated with greater severity of symptoms at first hospitalization with psychotic symptoms (OR = 2.18, 95% CI = 1.25–3.82), schizoid personality traits (OR = 1.62, 95% CI = 1.02–2.57) and impairment in a first-order false belief task (OR = 4.26, 95% CI = 1.05–17.31) in the multivariate models. Conclusions: Symptom severity at illness onset, premorbid schizoid personality traits and ToM impairment emerged as predictors of SA in this FEP sample, which, if replicated, may be useful in identifying high-risk groups and implementing more targeted suicide prevention programs in FEP