Early intervention program cuts suicide, self-harm rates in schizophrenia

Among patients with first-episode schizophrenia, an extended early intervention service may lower the incidence of suicide and self-harm, according to a study.

In Hong Kong, the Early Assessment Service for Young People With Psychosis (EASY) was established in 2001 to provide a 2-year, phase-specific intervention for patients aged 15 to 25 years with first-episode psychosis. Then, in 2011, this service was expanded to a 3-year program for patients aged 15 to 64 years (EASY Plus).

The analysis included 37,040 patients (mean age at schizophrenia onset 39 years, 82.6 percent older than 25 years, 53.0 percent female) with first-episode schizophrenia between 15 and 64 years of age. Researchers assessed the changes in self-harm and suicide rates before and after the implementation of an early intervention services program. The exposure period was defined as between April 2012 and March 2021 for the 1-year-time-lag analysis.

The 1-year-time-lag analysis showed an immediate decrease in self-harm rates among patients aged 26–44 years (rate ratio [RR], 0.77, 95 percent confidence interval [CI], 0.59–1.00), among those aged 45–64 years (RR, 0.70, 95 percent CI, 0.49–1.00), and among male patients (RR, 0.71, 95 percent CI, 0.56–0.91). Notably, there was a marked and sustained decrease in self-harm incidents among all patients (age 15–25 years: RR, 0.98; age 26–44 years: RR, 0.98; age 45–64 years: RR, 0.97).

Likewise, suicide rates dropped swiftly following the implementation of the EASY Plus program among patients aged 15–25 years (RR, 0.33, 95 percent CI, 0.14–0.77) and those aged 26–44 years (RR, 0.38, 95 percent CI, 0.20–0.73).

Compared with the counterfactual scenario, the EASY Plus program might have reduced self-harm episodes by 6,302 among patients aged 26–44 years.