Sümeyra N Tayfur, Zhiqian Song, Fangyong Li, Iruma Bello, Melanie E Bennett, Monica E Calkins, John A Cosgrove, Lisa Dixon, John Hsu, John M Kane, Molly A Lopez, Piper Meyer-Kalos, Tara A Niendam, Dost Öngür, Delbert Robinson, Alejandro Szmulewicz, Sophia Vinogradov, Jenifer L Vohs, Alan Breier, Vinod H Srihari
Suicidal ideation and attempts are common in first-episode psychosis (FEP), but less is known about how these outcomes change in large, community-based, coordinated specialty care (CSC) settings. This longitudinal cohort study examined 2951 individuals with FEP enrolled in 87 CSC clinics across 15 states in the Early Psychosis Intervention Network between 2019 and 2024. Suicide-related outcomes were assessed at admission and every 6 months for up to 2 years. At admission, 34% reported suicidal ideation and 7% reported a suicide attempt in the previous 6 months. By 24 months, the odds of ideation and attempts had declined substantially. Younger age, female sex, White race, non-Hispanic ethnicity and longer duration of untreated psychosis (DUP) were associated with higher odds of ideation, with younger age, longer DUP and prior psychiatric hospitalisation being associated with higher odds of attempt. Six participants (0.2%) died by suicide. The findings support early detection and ongoing suicide risk monitoring during CSC.