Suicidal behaviour in psychosis: Prevalence and predictors from a randomised controlled trial of case management

BACKGROUND: It is unclear whether intensive case management influences the prevalence of suicidal behaviour in patients with psychosis. AIMS: To compare the effect of intensive case management and standard care on prevalence of suicidal behaviour in patients with chronic psychosis. METHOD: Patients with established psychosis (n = 708) were randomised either to intensive case management or to standard care. The prevalence of suicidal behaviour was estimated at 2-year follow-up and compared between treatment groups. Suicide attempters and non-attempters were compared on multiple socio-demographic and clinical variables to identify predictors of suicidal behaviour. RESULTS: There was no significant difference in prevalence of suicidal behaviour between treatment groups. Recent attempts at suicide and multiple recent hospital admissions best predicted future attempts. CONCLUSIONS: Intensive case management does not appear to influence the prevalence of suicidal behaviour in chronic psychosis. Predictors identified in this study confirm some previous findings.