Untreated psychotic illness in the survivors of violent suicide attempts

Background: Recent studies suggest that violence is more common in the first episode of psychosis than after treatment. Aim: To estimate the proportion of survivors of violent suicide attempts during psychotic illness who had not previously received treatment with antipsychotic medication. Methods: An audit of the medical records of patients admitted to an inner city trauma centre after having survived a jump of more than 3m or a self-inflicted gunshot wound or stab wound to a vital body part. Results: There were 88 survivors of violent suicide attempts. Thirty-seven of those had a psychotic illness, including 33 with a schizophrenia-spectrum psychosis. Of the 37, 18 (48.6%, 95% confidence interval (CI) 32.3-65.0%) had never received treatment for psychosis. Conclusion: As first episode psychosis is less common than previously treated psychosis, there appears to be a higher risk of violent suicide attempts during the first episode of psychosis than later in the illness.