Suicidal behaviour in psychosis: prevalence and predictors from a randomised controlled trial of case management - Report from the UK700 trial

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. Declaration of interest E.W. was funded by a Wellcome Training Fellowship. The UK700 trial was funded by grants from the UK Department of Health and NHS Research and Development programme.