***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background : Very little research has been conducted in patients with first-episode psychosis using a dimensional approach . Affective dimensional representations might be useful to predict the clinical course and treatment needs in such patients . Methods : Weincluded 112 patients with first-episode psychosis in a longitudinal- prospect i ve study with a five-year follow-up ( N = 82 ) .  Logistic analyses  were performed to determine the predictive factors associated with depressive , manic , activation , and dysphoric dimensions . Results : High scores on the depressive dimension were associated with the best prognosis . On the other h and , high scores on the activation dimension and the manic dimension were associated with a poorer prognosis in terms of relapses . Only the dysphoric dimension was not associated with syndromic or functional prognosis . Conclusion : Our results suggest that the pattern of baseline affective symptoms helps to predict the course of psychotic illness . Therefore , the systematic assessment of affective symptoms would enable us to draw important conclusions regarding patients ’ prognosis . Interventions for patients with high scores on manic or activation dimensions could be beneficial in decreasing relapses in first-episode psychosis BACKGROUND Patients with first-episode psychosis comprise a high-risk group in terms of suicide . AIMS To identify predictive factors for suicidal behaviour and to examine the effect of integrated treatment on suicidal behaviour and hopelessness . METHOD A total of 341 patients with a first-episode schizophrenia-spectrum disorder were r and omised to integrated treatment or treatment as usual . RESULTS During the 1-year follow-up period , 11 % attempted suicide . This was associated with female gender , hopelessness , hallucinations and suicide attempt reported at baseline , with the two latter variables being the only significant ones in the final multivariate model . The integrated treatment  reduced hopelessness . CONCLUSIONS Hallucinations and suicide attempt before inclusion in the study were the most significant predictors of suicide attempt in the follow-up period IMPORTANCE Up to 1 million persons die by suicide annually . However , a lack of risk markers makes suicide risk assessment one of the most difficult areas of clinical practice . OBJECTIVE To assess psychotic symptoms ( attenuated or frank ) as a clinical marker of risk for suicide attempt . DESIGN , SETTING , AND PARTICIPANTS Prospect i ve cohort study of 1112 school-based adolescents ( aged 13 - 16 years ) , assessed at baseline and at 3 and 12 months for self-reported psychopathology , psychotic symptoms , and suicide attempts . MAIN OUTCOMES AND MEASURES Suicide attempts at the 3- and 12-month follow-up and acute suicide attempts ( defined as those occurring in the 2 weeks before an assessment ) . RESULTS Of the total sample , 7 % reported psychotic symptoms at baseline . Of that sub sample , 7 % reported a suicide attempt by the 3-month follow-up compared with 1 % of the rest of the sample ( odds ratio [ OR ] , 10.01 ; 95 % CI , 2.24 - 45.49 ) , and 20 % reported a suicide attempt by the 12-month follow-up compared with 2.5 % of the rest of the sample ( OR , 11.27 ; 95 % CI , 4.44 - 28.62 ) . Among adolescents with baseline psychopathology who reported psychotic symptoms , 14 % reported a suicide attempt by 3 months ( OR , 17.91 ; 95 % CI , 3.61 - 88.82 ) and 34 % reported a suicide attempt by 12 months ( OR , 32.67 ; 95 % CI , 10.42 - 102.41 ) . Adolescents with psychopathology who reported psychotic symptoms had a nearly 70-fold increased odds of acute suicide attempts ( OR , 67.50 ; 95 % CI , 11.41 - 399.21 ) . Differences were not explained by nonpsychotic psychiatric symptom burden , multimorbidity , or substance use . In a causative model , the population -attributable fraction of suicide attempts would be 56 % to 75 % for psychotic symptoms . CONCLUSIONS AND RELEVANCE Adolescents with psychopathology who report psychotic symptoms are at clinical high risk for suicide attempts . More careful clinical assessment of psychotic symptoms ( attenuated or frank ) in mental health services and better underst and ing of their pathological significance are urgently needed OBJECTIVES Approximately one third of people with early psychosis report post-traumatic symptoms , some of which are thought to arise from traumatic experiences associated with psychosis itself . This prospect i ve study tested hypotheses based on retrospective findings that threat appraisal s of voices , persecutors , or the new label of ' mental health patient ' predict symptoms of post-traumatic stress disorder ( PTSD ) . METHODS Appraisal s of power and threat from voices and other persecutors and appraisal s of the threat posed to identity by the diagnosis were assessed during the first acute phase of psychosis . Eighteen months later , PTSD symptom levels and diagnosis were established . DESIGN Prospect i ve . RESULTS Of 39 participants who completed the follow-up phase , 12 ( 31 % ) met criteria for PTSD diagnosis . Nineteen ( 49 % ) of the participants were still distressed by memories of their psychosis or the associated treatment . During the acute phase of psychosis , appraisal s of threat from voices and persecutors were strongly associated with distress . With the exception of the perceived ability to cope with threat , none of these appraisal s were predictive of subsequent post-traumatic stress however . Similarly , only one appraisal of the diagnosis ( loss of control ) was predictive of PTSD . CONCLUSION It may be that retrospective studies have overestimated the influence of c and i date appraisal s in predicting PTSD . It might also be that assessment s made during the acute phase of psychosis preceded a key phase of psychological processing that takes place during the immediate aftermath of the psychotic episode . A staged prospect i ve design is required to uncover the true impact of psychosis on PTSD AIM To identify predictors for developing a higher suicidal tendency during treatment of first-episode psychosis . METHODS In a prospect i ve follow-up study , we examined clinical factors collected at treatment initiation as predictors for developing a higher suicidal tendency among patients in the first year of treatment of psychosis . Patients were grouped and ranked according to their highest suicidal tendency in the year before treatment : not suicidal , suicidal thoughts , suicidal plans or suicide attempt(s ) . Predictors for becoming more suicidal in the first year of treatment were examined on group level in multivariate logistic regression analyses . We assessed patients ' suicidal tendency and clinical factors using vali date d interviews and rating scales .  Analysis included 386 patients . RESULTS Among patients with some suicidal tendency a one-point increase score on hallucinations significantly predicted developing a higher suicidal tendency , whereas a one-point increase score on delusions was preventive of this . Feeling hopeless was highly associated with suicide attempt in those with earlier suicide attempt . CONCLUSION The risk of suicide attempt did not differ between patient groups with suicidal thoughts , plans or suicide attempt .  In first year of treatment of psychosis , hallucinations increased the risk for becoming more suicidal , whereas delusions reduced this risk in already suicidal patients BACKGROUND Poorly defined cohorts and weak study design s have hampered cross-cultural comparisons of course and outcome in schizophrenia . AIMS To describe long-term outcome in 18 diverse treated incidence and prevalence cohorts . To compare mortality , 15- and 25-year illness trajectory and the predictive strength of selected baseline and short-term course variables . METHODS Historic prospect i ve study . St and ardised assessment s of course and outcome . RESULTS About 75 % traced . About 50 % of surviving cases had favourable outcomes , but there was marked heterogeneity across geographic centres . In regression models , early ( 2-year ) course patterns were the strongest predictor of 15-year outcome , but recovery varied by location ; 16 % of early unremitting cases achieved late-phase recovery . CONCLUSIONS A significant proportion of treated incident cases of schizophrenia achieve favourable long-term outcome . Sociocultural conditions appear to modify long-term course . Early intervention programmes focused on social as well as pharmacological treatments may realise longer-term gains Little is known about the longitudinal relationship of hopelessness to attempted suicide in psychotic disorders . This study addresses this gap by assessing  hopelessness  and  attempted suicide  at multiple time-points over 10 years in a first-admission cohort with psychosis ( n = 414 ) . Approximately one in five participants attempted suicide during the 10-year follow-up , and those who attempted suicide scored significantly higher at baseline on the Beck Hopelessness Scale . In general , a given assessment of hopelessness ( i.e. , baseline , 6 , 24 , and 48 months ) reliably predicted attempted suicide up to 4 to 6 years later , but not beyond . Structural equation modeling indicated that hopelessness prospect ively predicted attempted suicide even when controlling for previous attempts . Notably , a cut-point of 3 or greater on the Beck Hopelessness Scale yielded sensitivity and specificity values similar to those found in nonpsychotic population s using a cut-point of 9 . Results suggest that hopelessness in individuals with psychotic disorders confers information about suicide risk above and beyond history of attempted suicide . Moreover , in comparison with nonpsychotic population s , even relatively modest levels of hopelessness appear to confer risk for suicide in psychotic disorders This article reports the analysis of prospect ively gathered data on eight young adults who committed suicide during an ongoing longitudinal study of long-term treatment of schizophrenia in the community . Young adult men with an early onset of psychiatric illness were identified as a high-risk subgroup . At the time of admission to the study , the subjects who eventually committed suicide reported significantly more distress and tended to be less satisfied with their lives than the other subjects . Specifically , baseline measures of self-reported subjective distress were consistently predictive of later suicide , whereas interviewer-rated measures and postbaseline assessment s were not BACKGROUND Those with first-episode psychosis are at high-risk of suicide . AIMS To identify predictive factors for suicidal thoughts , plans and attempts , and to investigate the rate of suicides and other deaths during the 5 years after first diagnosis and initiation of treatment . METHOD A longitudinal , prospect i ve , 5-year follow-up study of 547 individuals with first-episode schizophrenia spectrum psychosis . Individuals presenting for their first treatment in mental health services in two circumscribed urban areas in Denmark were included in a r and omised controlled trial of integrated v. st and ard treatment . All participants were followed in the Danish Cause of Death Register for 5 years . Suicidal behaviour and clinical and social status were assessed using vali date d interviews and rating scales at entry , and at 1- and 2-year follow-ups . RESULTS Sixteen participants  died during the follow-up . We found a strong association between suicidal thoughts , plans and previous attempts , depressive and psychotic symptoms and young age , and with suicidal plans and attempts at 1- and 2-year follow-up . CONCLUSIONS In this first-episode cohort depressive and psychotic symptoms , especially hallucinations , predicted suicidal plans and attempts , and persistent suicidal behaviour and ideation were associated with high risk of attempted suicide 
    Output:
    
Depressive symptoms during FEP are associated with increased longer-term risk of suicidal behaviour .