Background: Individuals with psychosis symptoms are at high risk for suicidality. The prevalence and correlates of suicidality in clinical high risk for psychosis (CHR-P) have yet to be clarified. This study reports on the prevalence and clinical correlates of suicidality in a clinical CHR-P sample. Method: Participants (n = 135) included CHR-P clients at a CHR-P community specialty clinic, who participated in a clinical assessment between 2017 and 2022. Assessments measured attenuated psychosis symptoms, suicidality, clinical covariates, and functioning. Frequency analyses assessed the prevalence of lifetime suicidal ideation and attempts and T-test and Chi-square identified clinical correlates. Logistic regression assessed the relationship between significant clinical correlates and lifetime suicide attempts. Results: Sixty five percent of participants at CHR-P endorsed lifetime suicidal ideation, while 22.2% reported at least one lifetime attempt. Correlates for lifetime suicidal ideation included self-reported gender expansive identity, hopelessness, depression, trauma, obsessive compulsive symptoms, insight: reflectiveness, trauma diagnoses, mood disorder diagnoses, and perceptual abnormalities/hallucinations. Significant correlates for lifetime suicide attempts included self-reported hopelessness, depression, trauma diagnosis and mood disorder diagnosis. Conclusion: CHR-P clients are at a higher risk for suicidal ideation and attempts compared to the general population. Correlates of suicidality may be diagnostically heterogeneous and therefore interventions should be tailored to specific clinical needs. Clients with trauma-disorder diagnoses may be at highest risk for suicidality. Continued intervention and longitudinal research is needed to clarify causal risk factors and establish evidence-based treatments for suicidality in CHR-P.

Aim: Psychotic disorders and obsessive-compulsive disorder (OCD) commonly co-occur. Likewise, subthreshold psychosis symptoms (clinical high risk for psychosis; CHR-p) and obsessive-compulsive symptoms (OCS) commonly overlap and may be difficult to differentiate. Previous work suggests some notable differences between OCS and psychosis include insight and the content of thoughts and experiences. Methods: The current study explored the overlap between OCS and psychosis symptoms in a CHR-p sample. Results: Results demonstrated 13.5% of the sample experienced co-morbid OCD and CHR-p. Individuals with comorbid OCD and CHR-p experienced no other significant differences in presenting concerns, including psychosis symptoms, social or role functioning, anxiety, or depression. Exploratory factor analyses conducted on the CFOCI-A revealed two subtype factors: 1) checking and counting, and 2) intrusive thoughts and images of harm/guilt. The checking and counting factor was significantly correlated with depression and social anxiety. The intrusive thoughts and images of harm/guilt factor was significantly correlated with unusual thought content, suspiciousness and persecutory ideas, attenuated positive symptoms, and social anxiety. Conclusions: These findings suggest individuals who experience intrusive thoughts and images may be more likely to rate on positive symptoms, while individuals with checking and counting symptoms may not rate on positive symptoms, though may experience greater levels of depression.