Anxiety Disorders Associated With Suicidal Ideation and Suicide Attempts in the National Comorbidity Survey

Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.
Journal of Nervous & Mental Disease (Impact Factor: 1.69). 07/2005; 193(7):450-4. DOI: 10.1097/01.nmd.0000168263.89652.6b
Source: PubMed


This study examined the relationship between anxiety disorders and suicidal ideation or suicide attempts in a nationally representative sample (N = 5877; age, 15-54; response rate, 82.4%). A modified version of the Composite International Diagnostic Interview was used to make DSM-III-R mental disorder diagnoses. Two multivariate logistic regression analyses were performed with suicidal ideation (N = 754) and suicide attempts (N = 259) as dependent variables. In each regression, the independent variables entered were lifetime social phobia, panic disorder, agoraphobia, generalized anxiety disorder, simple phobia, and posttraumatic stress disorder (PTSD). Covariates in the analyses were sociodemographics, lifetime mood disorders, substance use disorders, nonaffective psychosis, antisocial personality disorder, and presence of three or more lifetime DSM-III-R diagnoses. PTSD was significantly associated with suicidal ideation (adjusted odds ratio = 2.79; p < 0.01) and suicide attempts (adjusted odds ratio = 2.67; p < 0.01). None of the other anxiety disorders were significantly associated with suicidal ideation or attempts. The robust association between PTSD and suicide attempts has important implications for psychiatric assessment of suicidal behavior. Future research is required to investigate the mechanisms underlying the relationship between PTSD and suicidal behavior.

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Available from: Jitender Sareen
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    • "and SI Suicidal thoughts or behaviors could be seen as the ultimate form of avoidance and escape for individuals experiencing severe levels of anxiety ( Sareen , Cox , et al . , 2005 ) . Alternatively , SI and anxiety disorders may share risk factors , such as traumatic child - hood experiences ( Johnson et al . , 2002 ; MacMillan et al . , 2001 ; Sareen , Cox , et al . , 2005 ) . SI and anxiety disorders may also have similar biological mechanisms . For example , low levels of hydrox - yindoleacetic acid in cerebrospinal fluid ( CSF - HIAA , a metabolite of serotonin ) are correlated with both anxiety and suicidality ( Fawcett , Busch , Jacobs , Kravitz , & Fogg , 1997 ; Nordström et al . , 1994 ) ."
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    ABSTRACT: Suicidal behaviors are of significant concern for the individuals displaying such behavior and for service providers who encounter them. Using nationally representative samples of Canadian and American adults, we aimed to examine: Whether age moderated the relationship between having any anxiety disorder and suicide ideation (SI), the prevalence of SI among younger and older adults, and whether age and individual anxiety disorders were differentially associated with SI. Age moderated the relationship between any anxiety disorder and SI among Americans only. Past-year SI was less prevalent among older, compared to younger, adults; Though, nearly every anxiety disorder was associated with increased odds of SI among younger and older Canadian and American adults after controlling for covariates. Effect sizes were particularly large for older American adults, but were coupled with large confidence intervals. Findings contribute to a growing literature suggesting that SI in the context of anxiety is a highly prevalent and complex mental health problem across the adult lifespan.
    Full-text · Article · Sep 2014 · Journal of Anxiety Disorders
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    • "Several studies have consistently shown that PTSD is associated with increased likelihood of suicidal behavior (Cougle, Keough, Riccardi, & Sachs-Ericsson, 2009; Davidson, Hughes, & Blazer, 1991; Ferrada- Noli, Asberg, Ormstad, Lundin, & Sunbdom, 1998; Helzer, Robins, & McEvoy, 1987; Kessler, Sonnega, Bromet, & Nelson, 1995; Kotler, Iancu, Efroni, & Amir, 2001; Nepon, Belik, Bolton, & Sareen, 2010; Sareen, Houlahan, Cox, & Asmundson, 2005; Tarrier & Gregg, 2004; Wilcox, Storr, & Breslau, 2009; Wunderlich, Bronisch, & Wittchen, 1998). In a study by Sareen et al. (2005), which examined the relationship of individual anxiety disorders with both suicidal ideation and suicide attempts in a nationally representative sample, it was found that PTSD was the only anxiety disorder that was independently associated with both suicidal ideation and suicide attempts. A study by Nepon et al. (2010) which adjusted for all 10 DSM-IV personality disorders, as well as Axis I disorders, found that both PTSD and panic disorder were significantly associated with lifetime suicide attempts. "
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    ABSTRACT: Individuals with posttraumatic stress disorder are at increased risk for suicide attempts. The present study aimed to determine which of the specific DSM-IV symptoms of posttraumatic stress disorder (PTSD) are independently associated with suicide attempts. Data came from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). The NESARC has a sample size of N = 34,653. The full sample size included in analyses was 2322 individuals with PTSD. Among individuals with lifetime PTSD, after adjusting for sociodemographic factors, as well as any mood, substance, personality, or anxiety disorder (excluding PTSD), increasing numbers of re-experiencing and avoidance symptoms were significantly correlated with suicide attempts. Of the specific symptoms, having physical reactions by reminders of the trauma, being unable to recall some part of it, and having the sense of a foreshortened future, were all associated with suicide attempts. These findings will help extend our understanding of the elevated risk for suicide attempts in individuals with PTSD.
    Full-text · Article · Mar 2014 · Journal of anxiety disorders
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    • "in patients with PTSD. The lifetime incidence of suicide attempts and ideation in patients with PTSD was second only to that in individuals with depression (Sareen et al., 2005). However, although there are many studies suggesting that suicide is an important cause of death in veterans and the risk for intentional death continues to be high many years after service, the exact nature of this association is still quite controversial. "
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    ABSTRACT: Posttraumatic stress disorder (PTSD) is frequently associated with suicidal ideation and suicide attempts. Suicide is an important cause of death in veterans, and the risk for intentional death continues to be high many years after service. The aim of the present study was to investigate whether there is a relationship between PTSD and suicidal behavior among veterans. We also discussed the risk factors of suicide among war veterans with PTSD. A systematic review was conducted focusing on war-related PTSD and suicidal behavior. A total of 80 articles from peer-reviewed journals were identified, 34 were assessed for eligibility, and 16 were included. Having a history of PTSD is associated with higher rates of morbidity and mortality and increased the risk for suicidal behavior. The association between PTSD and suicidal behavior was confirmed by the presence of other risk factors and high rates of comorbidity. Current suicidal behavior should be adequately assessed in war veterans.
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