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 3 m 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.