Early Intervention in the Real World Prevalence of suicide risk factors in people at ultra-high risk of developing psychosis: a service auditeip_302 375..380 Paul Hutton, 1,3 Samantha Bowe, 2 Sophie Parker 2,3 and Sarah Ford 3 1 Psychosis Research Unit (PRU) and 2 Early Detection and Intervention Team (EDIT), Greater Manchester West Mental Health Foundation NHS Trust, and 3 University of Manchester, Manchester, UK Corresponding author: Dr Paul Hutton, Psychosis Research Unit, Psychology Department, Greater Manchester West Mental Health NHS Foundation Trust, Bury New Road, Prestwich, Manchester M25 3BL, UK. Email: paulhutton@nhs.net Received 3 September 2010; accepted 28 May 2011 Abstract Background: Little data is available on the prevalence of suicide risk factors in people at ultra-high risk (UHR) of developing psychosis. Aim: The aim of this study was to provide an estimate of the cross- sectional prevalence of possible suicide risk factors in those attending a routine clinical service for people at UHR of developing psychosis. Methods: For all patients in treat- ment (n = 34) over a 4-week period, levels of suicidal ideation and depres- sion upon entry to the service were assessed by auditing intake scores on the Beck Depression Inventory, second edition. Level of engagement with services, social isolation, sub- stance and alcohol misuse, ready access to means, current suicidal ideation, previous suicide attempts, current or previous self-harm, expressions of concern from others, depression, agitation, hopelessness, worthlessness, suspiciousness and fears of mental disintegration were all assessed by case note review and interview with the treating clinician. Results: There was a high prevalence of at least mild suicidal ideation (58.8%, n = 20) and severe depressed mood (47%, n = 16) in this client group at point of entry to the service. Seven people (20.6%) had engaged in serious self-harm (including attempted suicide) during the time they were in contact with the service. Forty-seven per cent (n = 16) reported at least 27 suicide attempts between them; the mean number of attempts being 1.69 (standard deviation = 1.08). Conclusion: Suicide risk was high in this small sample of people at UHR of developing psychosis. Controlled research with larger samples and better methodology is urgently required to inform legal, ethical and scientific debates surrounding this group. Key words: cognitive behaviour therapy, preventative psychiatry, psychotic disorders, suicide, ultra-high risk group. INTRODUCTION The Salford Early Detection and Intervention Team (EDIT) is based within a UK National Health Service primary care setting and provides assess- ment, cognitive therapy and elements of case man- agement to people at ultra-high risk (UHR 1 ) of developing psychosis, in line with the treatment framework outlined by French and Morrison. 2 A single centre trial of this approach found it to be effective at reducing or delaying transition to psychosis. 3,4 This is currently being evaluated further in a multi-centre trial. The likely benefits to UHR patients of being treated in primary care (e.g. reduced stigma, increased acceptability) must be weighed against the possibility that they present a level of risk of serious self-harm, which might be more appropri- ately managed in a secondary care setting. However, there is very little data available to inform any debate. A very recent study of 106 people with a schizophrenia diagnosis retrospectively assessed Early Intervention in Psychiatry 2011; 5: 375–380 doi:10.1111/j.1751-7893.2011.00302.x First Impact Factor released in June 2010 and now listed in MEDLINE! © 2011 Blackwell Publishing Asia Pty Ltd 375