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Suicidality and Problem-Solving Skills among Individuals with First-Episode Psychosis Participating in Coordinated Specialty Care
Individuals with psychotic disorders are at elevated risk to die from suicide, with the greatest period of risk occurring in the first few years following the first onset of psychotic symptoms. Outside of the schizophrenia literature, social problem-solving skills have been shown to be negatively associated with suicidality, with higher levels of social problem-solving skills associated with lower suicidality. Drawing on this literature and the growing movement promoting early intervention for psychotic disorders, we examined the longitudinal course of suicidality and social problem-solving skills among individuals with first-episode psychosis participating in Coordinated Specialty Care (CSC). Our data suggest that individuals with first-episode psychosis experience a reduction in suicidality over the first six months of participation in CSC and that this reduction is mediated by a concurrent increase in social problem-solving skills. Post-hoc analyses revealed that the increase in social problem-solving skills was moderated by participants’ duration of psychotic illness, with people with a shorter duration of illness experiencing greater improvements in social problem-solving abilities over the first six months of CSC. In total, the results suggest that the benefits of CSC may extend beyond improvements in mental health symptoms and quality of life and highlight potential therapeutic targets through which CSC programs can optimize reductions in suicidality among the individuals that they serve.