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Prevalence and Clinical Correlates of Suicidality in Individuals at Clinical High Risk for Psychosis
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  • Julia Pfluger,
  • James B. Green,
  • Wenhui Qi,
  • Claire Goods,
  • Joey Rodriguez,
  • Michelle West,
  • Matcheri Keshavan,
  • Michelle Friedman-Yakoobian
Julia Pfluger
Beth Israel Deaconess Medical Center Department of Psychiatry

Corresponding Author:jpfluger@bidmc.harvard.edu

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James B. Green
Beth Israel Deaconess Medical Center Department of Psychiatry
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Wenhui Qi
Northeastern University
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Claire Goods
Beth Israel Deaconess Medical Center Department of Psychiatry
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Joey Rodriguez
Beth Israel Deaconess Medical Center Department of Psychiatry
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Michelle West
University of Colorado Anschutz Medical Campus Department of Psychiatry
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Matcheri Keshavan
Beth Israel Deaconess Medical Center Department of Psychiatry
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Michelle Friedman-Yakoobian
Beth Israel Deaconess Medical Center Department of Psychiatry
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Abstract

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.
12 Aug 2024Submitted to Early Intervention in Psychiatry
14 Aug 2024Submission Checks Completed
14 Aug 2024Assigned to Editor
14 Aug 2024Review(s) Completed, Editorial Evaluation Pending
24 Aug 2024Reviewer(s) Assigned
23 Sep 2024Editorial Decision: Revise Minor