The development of insight and its relationship to suicidality over one year follow-up in patients with first episode psychosis

Poster A12, Thursday, October 20, 11:30 am - 1:00 pm, Le Baron

Elizabeth Ann Barrett1, Erlend Mork, Ann Faerden, Ragnar Nesvag, Ingrid Agartz, Ole A. Andreassen, Ingrid Melle; 1Oslo University Hospital, Oslo, Norway

Introduction: Insight into psychosis has been linked to suicidality, although inconsistently. The co-variation between insight and suicidality over time is under-investigated. The aim of the present study was to investigate predictors of suicidality in patients with first episode of psychosis (FEP) over one year, focusing on the relationship between insight and suicidality. Methods: Patients with FEP (n=146) were interviewed as soon as possible after treatment start and at one year follow-up. Results: At baseline 37% of patients were suicidal, significantly reduced to 20% at follow-up. The effect of insight on suicidality was in different directions at different time-points, with insight at baseline increasing – and insight at follow-up decreasing the risk of suicidality at follow-up. Patients with stable levels of insight across baseline and follow-up did not differ in risk for suicidality at follow-up. However, patients who lost insight from baseline to follow-up were more often suicidal at follow-up, while patients who gained insight were more seldom suicidal at follow-up. Other predictors of suicidality at follow-up were more depressive episodes before study entry, longer duration of untreated psychosis, more suicide attempts six months prior to follow-up, and depression at follow-up. Discussion: The results indicate that the effect of insight on suicidality in FEP-patients depends on time of assessment and of changes in insight. Gaining insight during treatment was associated with reduced risk for suicidality, while losing insight had the opposite effect, underlining the need to monitor insight over time and tailor interventions according to illness phase.

Topic Area: Diagnosis and Phenomenology

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