Suicide Attempts in Patients With Panic Disorder

Abstract

In a clinical sample of 100 outpatients with panic disorder, 42% had a history of suicide attempt. Female sex and being single, divorced, or widowed were associated with an increased risk of suicide attempt. Thirty-one (73.8%) of the suicide attempts occurred after the first panic attack and 27 (64.3%) after the onset of panic disorder. Eighty-eight of these patients met DSM-III-R criteria for at least one other diagnosis in addition to panic disorder. Moreover, 52% had a history of major depressive episode and 31% had a lifetime diagnosis of alcohol and/or other substance abuse. Compared with those who did not attempt suicide, those who attempted suicide were significantly more likely to have suffered from major depressive episode and alcohol or other substance abuse in their lifetime. Among the 35 patients with no comorbidity with either major depression or addictive behaviors, 17.1% had a history of suicide attempt. All had suffered from depressive symptoms and/or a personality disorder. The same association was found in four of 19 patients suffering from panic disorder only with or without agoraphobia.

Impulsivity in anxiety disorders

“…The studies conducted so far lead to conflicting and mixed data mainly on some behavioural aspects of impulsivity such as suicidality and aggression Weissman, Klerman et al 1989;Beck, Steer et al 1991;Lepine, Chignon et al 1993;Korn, Plutchik et al 1997;Pilowsky, Wu et al 1999). Taken as a whole, the findings tend to suggest that cyclothymic instability could be reasonably considered the basic state for both anxious/inhibited as well as impulsive/disinhibited manifestations of these patients van Valkenburg, Kluznik et al 2006).…”

“…The studies conducted so far lead to conflicting and mixed data mainly on some behavioural aspects of impulsivity such as suicidality and aggression Beck, Steer et al 1991;Lepine, Chignon et al 1993;Korn, Plutchik et al 1997;Pilowsky, Wu et al 1999). …”

“…Among the anxiety disorder patients (n = 45) the most frequent diagnosis was panic disorder with (26, 55.3%) and without (11,23.4%) agoraphobia; only one subject (1.8%) presented agoraphobia without panic disorder. Concerning the other anxiety disorders, 12 patients (25.5%) met diagnostic criteria for obsessive-compulsive disorder, nine (19.1%) for generalized anxiety disorder and seven (14.9%) for social anxiety disorder.…”

“…The relationship between Panic Disorder (PD) and impulsivity has not been adequately studied. Few data are available regarding behaviors strongly associated with impulsivity such as non premeditated suicidality and aggression [3][4][5], leading to discrepant findings [6][7][8][9][10][11][12][13]. For example, several studies [6,8] have reported a higher incidence of suicidal ideation and suicide attempts in subjects with panic attacks.…”

Personalidad y Trastorno de Pánico: Un estudio de revisión

“…A este respecto, cabe mencionar los estudios que relacionan el TP con la ideación o intentos suicidas. Los estudios indican que la ideación suicida se relaciona con síntomas depresivos, adicción a sustancias y comorbilidad en Eje II (Lepine, Chignon y Teherani, 1993) o también con presencia de depresión, TPe y mayor gravedad del TPA (Starcevic et al, 1999). Los pacientes con TP y comorbilidad en Eje II manifiestan sintomatología más grave y peores puntuaciones en funcionamiento social (Chambless et al, 1992;Ozkan y Altindag, 2005;Segui et al, 1999;Seivewright, Tyrer y Johnson, 2004;.…”