Self-harm in first-episode psychosis

Aims and method: Suicide in schizophrenia remains frequent. One of the best predictors of suicide, previous self-harm, is increasing in young people. The aim of this case-note review was to investigate the frequency of a history of self-harm for individuals presenting to psychiatric services with a first episode of psychosis in our local area and study their demographic characteristics. Results: A history of self-harm was found in 32% of the cohort. The predominant method of self-harm was self-laceration. In univariate analyses, age and gender were significant predictors of self-harming behaviour. Clinical implications: The rate of self-harm among those with first-episode psychosis is high. Efforts to reduce the rate of completed suicide in psychotic illness need to focus on this risk, which often predates contact with psychiatric services. This emphasises again the need for early detection and intervention in psychotic illness.