Is poor premorbid functioning a risk factor for suicide attempts in first-admission psychosis?

Shelly Bakst, Jonathan Rabinowitz, Evelyn J. Bromet

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Background: While poor premorbid functioning is associated with poorer outcomes in psychotic illnesses, little is known about whether it is also a risk factor for suicide attempts. Objective: The current study examined the association of premorbid functioning and suicide attempts in a county-wide cohort of first-admission inpatients. Method: Data were derived from participants of the Suffolk County Mental Health Project (n = 444) over the course of 48-month follow-up. Premorbid functioning was estimated and categorized (good vs. poor/declining) using the Premorbid Adjustment Scale (PAS). Results: Poorer premorbid functioning was significantly associated with increased likelihood of a suicide attempt prior to first psychiatric hospital admission. Specifically, 33.0% of participants with poor/declining premorbid functioning had a history of suicide attempts compared to 23.5% with good premorbid functioning. Among participants with a prior attempt (n = 126), poor premorbid functioning was significantly associated with an increased likelihood of additional attempts during the four years after first hospitalization. Conclusion: Identifying those with poor premorbid functioning and prior histories of attempts could help clinicians target high-risk patients. Thus, greater attention to persons with both risk factors may form the basis for early interventions aimed towards reducing the risk for subsequent suicide attempts.

Original languageEnglish
Pages (from-to)210-216
Number of pages7
JournalSchizophrenia Research
Volume116
Issue number2-3
DOIs
StatePublished - Feb 2010

Bibliographical note

Funding Information:
Funding for this study was provided by NIH grant MH44801 (E.J. Bromet, PI), the Elie Wiesel Chair (J. Rabinowitz), and the President's Doctoral Fellowship at Bar Ilan University (S. Bakst) and was part of doctoral research conducted there. All of the above sources of funding had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.

Keywords

  • First episode
  • Premorbid adjustment
  • Psychotic disorders
  • Schizophrenia
  • Suicide behaviors

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