Comorbid Anxiety and Suicidal Behaviors in American Adolescents With Major Depression

Abstract

The aim of this study was to evaluate the odds of association between suicidal behaviors and comorbid anxiety disorders in adolescents with major depressive disorder (MDD). Methods We included 122,020 adolescent inpatients with MDD from the Nationwide Inpatient Sample (NIS) and further grouped them by co-diagnosis of anxiety disorders. Logistic regression analysis was used to evaluate the odds ratio (OR) of suicidal behaviors due to comorbid anxiety disorders. Results Out of total MDD inpatients, 45.8% had comorbid anxiety disorders. Around 53.5% MDD inpatients with anxiety disorders had suicidal behaviors, which were significantly higher than seen in 52.6% non-anxiety cohort (P = 0.002). Comorbid anxiety disorders had a minimally positive association with suicidal behaviors and were not statistically significant (OR: 1.01; P = 0.710) after controlling the logistic regression analysis for demographic confounders and psychiatric comorbidities. MDD inpatients with comorbid psychotic disorders were positively associated (OR: 1.16; P = 0.007) with suicidal behaviors. Conclusions MDD with comorbid anxiety had a statistically non-significant association with suicidal behaviors in adolescents. Depression has a direct and independent effect on adolescent suicidal behaviors, whereas anxiety has a direct effect only on perpetuating depression. Early diagnosis and management of comorbid anxiety and psychosis with MDD reduce functional impairment and suicide risk in at-risk populations.

Substance Use Disorders (SUD) and Suicidal Behaviors in Adolescents: Insights From Cross-Sectional Inpatient Study

“…Major risk factors are being female, being of African American descent, exposure to bullying and violence, sexual orientation, alcohol and substance abuse, psychiatric comorbidities, poor familial, and social support [8]. SUD often coexist with psychiatric illnesses and further increases the suicide risk [9][10][11].…”

Nightmare Distress as a Risk Factor for Suicide Among Adolescents with Major Depressive Disorder

“…This result is consistent with that of a recent study, which showed no statistically significant correlation between MDD with comorbid anxiety and suicidal behavior. 67 Although the results of our study add to the understanding of suicide risk in adolescent patients with MDD, several limitations need to be considered. First, the data were collected using a cross-sectional study design, making it impossible to determine the direction of a causal relationship between nightmare stress and suicide risk.…”

“…This result is consistent with that of a recent study, which showed no statistically significant correlation between MDD with comorbid anxiety and suicidal behavior. 67 …”

Factors associated with suicidal behavior in graduate students: a scoping review

“…(3) Anxiety disorders themselves are not always associated with a higher prevalence of suicidal behavior; however, when they occur concomitantly with other psychiatric comorbidities, such as depressive disorders, they result in a summative effect on suicide risk. (20,22) The hypothesis of a summative effect on the risk of suicide caused by the co-occurrence of depressive symptoms and posttraumatic stress disorder symptoms was also observed in Chinese graduate students. (16) Use of substances such as alcohol and psychotropic drugs, and eating problems, depending on their severity, are also serious mental distress problems, especially when they occur during graduate studies, as they are associated with a higher risk for suicidal behavior in this population segment.…”