Panic disorder and suicidal ideation in primary care

Abstract

The purpose of this study was to ascertain whether panic disorder (PD) and suicidal ideation are associated in an inner-city primary care clinic and whether this association remains significant after controlling for commonly co-occurring psychiatric disorders. We surveyed 2,043 patients attending a primary care clinic using the Primary Care Evaluation of Mental Disorders (PRIME-MD) Patient Health Questionnaire, a screening instrument that yields provisional diagnoses of selected psychiatric disorders. We estimated the prevalence of current suicidal ideation and of common psychiatric disorders including panic disorder and major depression. A provisional diagnosis of current PD was received by 127 patients (6.2%). After adjusting for potential confounders (age, gender, major depressive disorder [MDD], generalized anxiety disorder, and substance use disorders), patients with PD were about twice as likely to present with current suicidal ideation, as compared to those without PD (adjusted odds ratio [AOR] = 1.84; 95% confidence interval [CI]: 1.06-3.18; P = .03). After adjusting for PD and the above-mentioned potential confounders, patients with MDD had a sevenfold increase in the odds of suicidal ideation, as compared to those without MDD (AOR = 7.00; 95% CI: 4.42-11.08; P < .0001). Primary care patients with PD are at high risk for suicidal ideation, and patients with PD and cooccurring MDD are at especially high risk. PD patients in primary care thus should be assessed routinely for suicidal ideation and depression.

A 1-year follow-up study of chest-pain patients with and without panic disorder

“…Recent research have revealed panic disorder as an independent risk factor for suicidal ideation in primary care patients (57); and a prospective population based study reported anxiety disorders, and among them PD, as risk factors for future suicidal ideation and attempts (58) when co-morbid disorders were controlled for. There is also some evidence that suicidal ideation increases over time in chest pain patients with PD (16), but the long-term association between PD and suicidal ideation in chest pain patients is unknown.…”

Anxiety and Anxiety Disorders

“…The onset of panic disorder is usually in early to middle childhood, affecting about 1-3 % of the population but as high as 7 % in an urban population (Goodwin et al 2001 ;Pilowsky et al 2006 ;Weissman et al 1997 ). It occurs more commonly among females and is often associated with depression and increased suicidal ideation (Goodwin et al 2001 ).…”

Handbook of Assessing Variants and Complications in Anxiety Disorders

“…Panic disorder and panic attacks are also associated with increased risk for suicidal ideation (Goodwin & Roy-Byrne, 2006 ;Pilowsky et al, 2006 ) . Individuals with panic disorder report similar levels of suicidal ideation as individuals with depressive disorders (Diaconu & Turecki, 2007 ) .…”

“…Self-report measures speci fi cally developed for use with children and adolescents include the Suicidal Ideation Questionnaire (SIQ; Reynolds, 1987 ) , the Suicidal Ideation Questionnaire-Junior (SIQ-JR; Reynolds, 1987 ) , the Suicidal Behaviors Questionnaire for Children (SBQ-C; Cotton & Range, 1993 ) , the Columbia Teen Screen (CTS; Shaffer, Wilcox, et al, 1996 ) , and the Child-Adolescent Suicidal Potential Index (CASPI; Pfeffer, Jiang, & Kakuma, 2000 ) . The SIQ is one of the most widely used measures for suicidal ideation in adolescents.…”