Prevalence of suicidal behaviour in adolescents and youth at ultra-high risk for psychosis: A systematic review and meta-analysis

Abstract Background Suicide remains a major risk factor for individuals suffering from schizophrenia and its prodromal state (i.e., Ultra-High Risk for Psychosis). However, less is known about the prevalence of suicidal behaviour among the adolescent and youth UHR population, a demographic vulnerabl...

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Main Authors: Shi Han Ang, Siddarth Venkateswaran, Mahir Bakulkumar Goda, Kuhanesan N. C. Naidu, Ganesh Kudva Kundadak, Mythily Subramaniam
Format: Article
Language:English
Published: Cambridge University Press 2025-01-01
Series:European Psychiatry
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Online Access:https://www.cambridge.org/core/product/identifier/S0924933825024447/type/journal_article
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author Shi Han Ang
Siddarth Venkateswaran
Mahir Bakulkumar Goda
Kuhanesan N. C. Naidu
Ganesh Kudva Kundadak
Mythily Subramaniam
author_facet Shi Han Ang
Siddarth Venkateswaran
Mahir Bakulkumar Goda
Kuhanesan N. C. Naidu
Ganesh Kudva Kundadak
Mythily Subramaniam
author_sort Shi Han Ang
collection DOAJ
description Abstract Background Suicide remains a major risk factor for individuals suffering from schizophrenia and its prodromal state (i.e., Ultra-High Risk for Psychosis). However, less is known about the prevalence of suicidal behaviour among the adolescent and youth UHR population, a demographic vulnerable to the psychosocial and environmental risk factors of suicide. This review aims to synthesise existing literature on the prevalence of suicidal ideation and behaviour in the adolescent and youth at Ultra-High Risk for Psychosis (UHR), and the associations between suicidal behaviour and its correlates. Methods The databases PsycINFO, PubMed, Embase, Cochrane Library, Web of Science, and Scopus were accessed up to July 2024. A meta-analysis of prevalence was subsequently performed for lifetime suicidal ideation, lifetime non-suicidal self-injury, lifetime suicidal attempt, and current suicidal ideation. A narrative review was also carried out for the correlates of suicidal behaviour amongst adolescents and youth in the UHR population. Results Studies were included in this meta-analysis. Meta-analysis revealed a high prevalence of lifetime suicidal ideation (58%), lifetime non-suicidal self-injury (37%), lifetime suicidal attempt (25%), and current (2 week) suicidal ideation (56%). The narrative review revealed that a personal transition to psychosis and a positive family history of psychosis were associated with suicidal attempts, while depression was associated with both suicidal attempts and suicidal ideation. Conclusion The prevalence of suicidal ideation and behaviour among UHR adolescents and youth is high and comparable to that of the general UHR population. Existing measures that mitigate suicide risk in the general UHR population should be adopted for the youth context.
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spelling doaj-art-c7ffbcb0c8d545e38c3cec6690ae86d12025-08-20T03:11:09ZengCambridge University PressEuropean Psychiatry0924-93381778-35852025-01-016810.1192/j.eurpsy.2025.2444Prevalence of suicidal behaviour in adolescents and youth at ultra-high risk for psychosis: A systematic review and meta-analysisShi Han Ang0https://orcid.org/0009-0006-8052-549XSiddarth Venkateswaran1Mahir Bakulkumar Goda2https://orcid.org/0009-0009-9824-732XKuhanesan N. C. Naidu3https://orcid.org/0009-0007-4118-9195Ganesh Kudva Kundadak4https://orcid.org/0000-0001-9157-2175Mythily Subramaniam5https://orcid.org/0000-0003-4530-1096Yong Loo Lin School of Medicine, National University of Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, SingaporeDepartment of Psychological Medicine, National University Hospital, Singapore Saw Swee Hock School of Public Health, National University of Singapore, SingaporeDepartment of Psychological Medicine, National University Hospital, Singapore Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, SingaporeDepartment of Psychological Medicine, National University Hospital, Singapore Research Division, Institute of Mental Health, Singapore Lee Kong Chian School of Medicine, Nanyang Technological University, SingaporeAbstract Background Suicide remains a major risk factor for individuals suffering from schizophrenia and its prodromal state (i.e., Ultra-High Risk for Psychosis). However, less is known about the prevalence of suicidal behaviour among the adolescent and youth UHR population, a demographic vulnerable to the psychosocial and environmental risk factors of suicide. This review aims to synthesise existing literature on the prevalence of suicidal ideation and behaviour in the adolescent and youth at Ultra-High Risk for Psychosis (UHR), and the associations between suicidal behaviour and its correlates. Methods The databases PsycINFO, PubMed, Embase, Cochrane Library, Web of Science, and Scopus were accessed up to July 2024. A meta-analysis of prevalence was subsequently performed for lifetime suicidal ideation, lifetime non-suicidal self-injury, lifetime suicidal attempt, and current suicidal ideation. A narrative review was also carried out for the correlates of suicidal behaviour amongst adolescents and youth in the UHR population. Results Studies were included in this meta-analysis. Meta-analysis revealed a high prevalence of lifetime suicidal ideation (58%), lifetime non-suicidal self-injury (37%), lifetime suicidal attempt (25%), and current (2 week) suicidal ideation (56%). The narrative review revealed that a personal transition to psychosis and a positive family history of psychosis were associated with suicidal attempts, while depression was associated with both suicidal attempts and suicidal ideation. Conclusion The prevalence of suicidal ideation and behaviour among UHR adolescents and youth is high and comparable to that of the general UHR population. Existing measures that mitigate suicide risk in the general UHR population should be adopted for the youth context. https://www.cambridge.org/core/product/identifier/S0924933825024447/type/journal_articleultra high riskfirst episode psychosisschizophreniasuicidechild and adolescent psychiatry
spellingShingle Shi Han Ang
Siddarth Venkateswaran
Mahir Bakulkumar Goda
Kuhanesan N. C. Naidu
Ganesh Kudva Kundadak
Mythily Subramaniam
Prevalence of suicidal behaviour in adolescents and youth at ultra-high risk for psychosis: A systematic review and meta-analysis
European Psychiatry
ultra high risk
first episode psychosis
schizophrenia
suicide
child and adolescent psychiatry
title Prevalence of suicidal behaviour in adolescents and youth at ultra-high risk for psychosis: A systematic review and meta-analysis
title_full Prevalence of suicidal behaviour in adolescents and youth at ultra-high risk for psychosis: A systematic review and meta-analysis
title_fullStr Prevalence of suicidal behaviour in adolescents and youth at ultra-high risk for psychosis: A systematic review and meta-analysis
title_full_unstemmed Prevalence of suicidal behaviour in adolescents and youth at ultra-high risk for psychosis: A systematic review and meta-analysis
title_short Prevalence of suicidal behaviour in adolescents and youth at ultra-high risk for psychosis: A systematic review and meta-analysis
title_sort prevalence of suicidal behaviour in adolescents and youth at ultra high risk for psychosis a systematic review and meta analysis
topic ultra high risk
first episode psychosis
schizophrenia
suicide
child and adolescent psychiatry
url https://www.cambridge.org/core/product/identifier/S0924933825024447/type/journal_article
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