Emotional abuse and stress are risk factors for suicidal behavior in people with first psychotic episodes

Institut de Recerca Sant Joan de Déu study associates stress and emotional abuse in childhood with a greater risk of suicidal behavior in young people with a first psychotic episode.

The study was coordinated by Dr Judith Usall, head of the IRSJD "Etiopathogenesis and treatment of severe mental disorders (MERITT)" group and researcher at Parc Sanitari Sant Joan de Déu (Parc Sanitari SJD) and CIBERSAM, it published in Psychatry Research. IRSJD's researchers, psychiatrists and psychologists from the Parc Sanitari Sant Joan de Déu and the SJD Barcelona Children's Hospital participated in the research. The principal authors are Marta Diago, a third-year psychology resident at Parc Sanitari SJD, and Regina Vila, a PhD Student in psychology at IRSJD.

According to the World Health Organization, more than 700,000 people die each year by suicide, becoming a significant public health problem. The most at-risk people with mental health problems, especially those with schizophrenia or psychotic disorders. And more worrying is the high incidence among the young population, being the fourth cause of death worldwide.

"The prevention of suicide is a significant action line for many governments. Our government created a 064 telephone line for attending and supporting people with suicidal thoughts", comments Dr Judith Usall.

Early action to reduce the incidence of suicidal behavior is the key

Acting early or detecting those factors predisposing to suicidal behavior is key to reducing the incidence. In recent years, different studies have determined childhood trauma's impact on suicidal behaviour. Physical, sexual and emotional abuse and physical and emotional neglect in childhood can be risk factors for suicide, especially in people with mental health problems.

"Our study focuses on analyzing whether there is a relationship between childhood traumatic experiences (CTEs) and people with a first psychotic episode (FPE). Specifically, we focus on this population for two reasons: people with an FPE are more vulnerable to show suicidal behavior, and to have experienced more traumatic experiences" comments researcher Marta Diago, co-author of the article.

The results showed that 59% of the patients with an FEP had suffered a CET. In addition, 52% of patients with FEP presented suicidal ideation, and 18% of these had made some suicide attempts.

Perceived stress and emotional abuse in childhood are two predictive factors

The study results show two risk factors for presenting suicidal behaviors among the population with a first psychotic episode. On the one hand, having suffered emotional abuse in childhood, and on the other, showing high-stress levels.

People with a first psychotic episode have a greater predisposition to show suicidal behavior than the general population. This fact increases if they have suffered behaviors of emotional abuse, such as bullying, in childhood or adolescence.

"It is essential to train mental health professionals to detect possible traumatic experiences in childhood and high levels of stress. And thus be able to carry out a better therapeutic approach in people who may be more susceptible to presenting suicidal behaviors. Early detection of risk factors is the key to reducing suicide in our population". Concludes Regina Vila, co-author of the article.

Reference paper

Diago M, Vila-Badia R, Serra-Arumí C, Butjosa A, Del Cacho N, Esteban Sanjusto M, Colomer-Salvans A, Sánchez L, Dolz M, Muñoz-Samons D, Profep G, Usall J. Emotional abuse and perceived stress: The most relevant factors in suicide behavior in first-episode psychosis patients. Psychiatry Res. 2022 Jun 30;315:114699. doi: 10.1016/j.psychres.2022.114699. Epub ahead of print. PMID: 35785562.

"It is essential to train mental health professionals to detect possible traumatic experiences in childhood and high levels of stress."