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BMC Psychiatry
Published in: BMC Psychiatry 1/2018

Open Access 01-12-2018 | Research article

Suicidal ideation in primary care patients suffering from panic disorder with or without agoraphobia

Authors: Tobias Teismann, Karoline Lukaschek, Thomas S. Hiller, Jörg Breitbart, Christian Brettschneider, Ulrike Schumacher, Jürgen Margraf, Jochen Gensichen, the Jena Paradies Study Group

Published in: BMC Psychiatry | Issue 1/2018

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Abstract

Background

Suicidal ideation is common in patients suffering from panic disorder. The present study investigated rates of suicidal ideation and risk factors for suicidal ideation in a sample of primary care patients suffering from panic disorder with or without agoraphobia.

Methods

A total of N = 296 patients [n = 215 (72.6%) women; age: M = 43.99, SD = 13.44] were investigated. Anxiety severity, anxiety symptoms, avoidance behavior, comorbid depression diagnosis, severity of depression, age, sex, employment status, living situation and frequency of visits at the general practitioner were considered as risk factors of suicidal ideation.

Results

Suicidal ideation was experienced by 25% of the respondents. In a logistic regression analysis, depression diagnosis and depression severity emerged as significant risk factors for suicidal ideation. Anxiety measures were not associated with suicidal ideation.

Conclusion

Suicidal ideation is common in primary care patients suffering from panic disorder with or without agoraphobia. Individuals with greater burden of mental illness in terms of mood disorder comorbidity and depressive symptomatology are especially likely to suffer from suicidal ideation.
Literature
1.
Lukaschek K, Engelhardt H, Baumert J, Ladwig KH. No correlation between rates of suicide ideation and completed suicides in Europe: analysis of 49,008 participants (55+) based on the survey of health, ageing and retirement in Europe (SHARE). Eur Psychiatry. 2015;30:874–9.CrossRef
2.
Bernal M, Haro JM, Bernert S, Brugha T, de Graaf R, Bruffaerts R, Lépine JP, de Girolamo G, Vilagut G, Gasquet I, Torres JV, Kovess V, Heider D, Neeleman J, Kessler R, Alonso J. Risk factors for suicidality in Europe: results from the ESEMED study. J Affect Disord. 2007;101:27–34.CrossRef
3.
Brown GK, Beck AT, Steer RA, Grisham JR. Risk factors for suicide in psychiatric outpatients: a 20-year prospective study. J Consult Clin Psychol. 2000;68:371–7.CrossRef
4.
Brown GK, Steer RA, Henriques GR, Beck AT. The internal struggle between the wish to die and the wish to live: a risk factor for suicide. Am J Psychiatry. 2005;162:1977–9.CrossRef
5.
Borges G, Chiu WT, Hwang I, Panchal BN, Ono Y, Sampson NA, Kessler RC, Nock MK. Prevalence, onset , and transitions among suicidal behaviors. In Nock MK, Borges G, Ono Y, editors. Suicide. Global perspectives from the WHO world mental health survey. Cambridge: Cambridge University Press; 2014. p. 65–74.
6.
Turecki G, Brent DA. Suicide and suicidal behavior. Lancet. 2016;387:1227–39.CrossRef
7.
Kanwar A, Prokop LJ, Sim LA, Feldstein D, Wang Z, Murad MH. The association between anxiety disorders and suicidal behavior: a systematic review and meta-analysis. Depress Anxiety. 2013;30:917–29.PubMed
8.
Weisman MM, Klerman GL, Markowith JS, Ouelette R, Phil N. Suicidal ideation and suicide attempts in panic disorder and attacks. N Engl J Med. 1989;321:1209–14.CrossRef
9.
Sareen J, Cox BJ, Afifi TO, de Graaf R, Asmundson GJG, ten Have M, Stein MB. Anxiety disorders and risk for suicidal ideation and suicide attempts. Arch Gen Psychiatry. 2005;62:1249–57.CrossRef
10.
Cox BJ, Direnfeld DM, Swinson RP, Norton GR. Suicidal ideation and suicide attempts in panic disorder and social phobia. Am J Psychiatry. 1994;151:882–7.CrossRef
11.
Fleet RP, Dupuis G, Marchand A, Burelle D, Arsenault A, Beitman MD. Panic disorder in emergency department chest pain patients. Am J Med. 1996;101:371–80.CrossRef
12.
Kroenke K, Spitzer RL, Williams JB, Monahan PO, Lowe B. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med. 2007;146:317–25.CrossRef
13.
Löwe B, Gräfe K, Zipfel S, Spitzer RL, Herrmann-Lingen C, Witte S, Herzog W. Detecting panic disorder in medical and psychosomatic outpatients: comparative validation of the hospital anxiety and depression scale, the patient health questionnaire, a screening question, and physicians’ diagnosis. J Psychosom Res. 2003;55:515–9.CrossRef
14.
Kessler RC, Chiu WT, Jin R, Ruscio AM, Shear K, Walters EE. The epidemiology of panic attacks, panic disorder, and agoraphobia in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2006;63:415–24.CrossRef
15.
Vannoy SD, Robins LS. Suicide-related discussions with depressed primary care patients in the USA: gender and quality gaps. A mixed methods analysis. BMJ. 2011;1:e000198.
16.
Luoma JB, Martin CE, Pearson JL. Contact with mental health and primary care providers before suicide: a review of the evidence. Am J Psychiatry. 2002;169:909–16.CrossRef
17.
Pirkis J, Burgess P. Suicide and recency of health care contacts: a systematic review. Br J Psychiatry. 1998;36:29–35.
18.
Bryan CJ, Britton PC. Treating self-directed violence in primary care settings. In: Bryan, CJ, editor. Preventing suicide attempts. A guide to brief treatments across clinical settings. New York: Routledge; 2015. p. 141–57.
19.
Nock MK, Borges G, Ono Y. Suicide. Global perspectives from the WHO world mental health survey. Cambridge: Cambridge University Press; 2014.
20.
Gensichen J, Hiller TS, Breitbart J, Teismann T, Brettschneider C, Schumacher U, Piwtorak A, König HH, Hoyer H, Schneider N, Schelle M, Blank W, Thiel P, Wensing M, Margraf J. Patient activation for anxiety disorders – study protocol of a cluster randomized controlled trial in primary care [ISRCTN64669297]. Trials. 2015;15:112.CrossRef
21.
Norman SB, Campbell-Sills L, Hitchcock CA, Sullivan S, Rochlin A, Wilkins KC, Stein MB. Psychometrics of a brief measure of anxiety to detect severity and impairment: the overall anxiety severity and impairment scale (OASIS). J Psychiatr Res. 2011;45:262–8.CrossRef
22.
Spitzer RL, Kroenke K, Williams JB. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. JAMA. 1999;282:1737–44.CrossRef
23.
Simon GS, Rutter CM, Peterson D, Oliver M, Whiteside U, Operskalski B, Ludman EJ. Do PHQ depression questionnaires completed during outpatient visits predict subsequent suicide attempt or suicide death? Psychiatr Serv. 2013;64:1195–202.CrossRef
24.
Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988;56:893–7.CrossRef
25.
Margraf J, Ehlers A. Beck-Angstinventar. Göttingen: Hogrefe; 2007.
26.
Norman SB, Hami-Cissell S, Means-Christensen AJ, Stein MB. Development and validation of an overall anxiety severity and impairment scale (OASIS). Depress Anxiety. 2006;23:245–9.CrossRef
27.
Chambless DL, Caputo GC, Jasin SE, Gracely EJ, Williams C. The mobility inventory for agoraphobia. Behav Res Ther. 1985;23:35–44.CrossRef
28.
Kroenke K, Spitzer RL, Williams JB. The PHQ-9 – validity of a brief depression severity measure. J Gen Intern Med. 2001;16:606–13.CrossRef
29.
Bomyea J, Lang AJ, Craske MG, Chavira D, Sherbourne CD, Rose RD, Golinell D, Campells-Sills L, Welch SS, Sullivan G, Bystritsky A, Roy-Byrne P, Stein MB. Suicidal ideation and risk factors in primary care patients with anxiety disorders. Psychiatry Res. 2013;30:60–5.CrossRef
30.
Warshaw MG, Massion AO, Peterson LG, Pratt LA, Keller MB. Suicidal behavior in patients with panic disorder: retrospective and prospective data. J Affect Disord. 1995;34:235–47.CrossRef
31.
Fawcett J, Scheftner MD, Fogg L, Clark DC, Young MA, Hedeker D, Dibbons R. Time-related predictors of suicide in major affective disorder. Am J Psychiatry. 1990;147:1189–94.CrossRef
32.
Yaseen ZS, Chartrand H, Mojtabai R, Bolton J, Galynker II. Fear of dying in panic attacks predicts suicide attempts in comorbid depressive illness. Depress Anxiety. 2013;30:930–9.PubMed
33.
Bruce ML, Ten Have TR, Reynolds CF, Katz II, Schulberg HC, Mulsant BH, Brown GK, McAvay GJ, Pearson JL, Alexopoulos GS. Reducing suicidal ideation and depressive symptoms in depressed older primary care patients: a randomized controlled trial. JAMA. 2004;291:1081–91.CrossRef
34.
Millner AJ, Lee MD, Nock MK. Single-item measurement of suicidal behaviors: validity and consequences of misclassification. PLoS One. 2015;10(10):e0141606.CrossRef
35.
Valentiner DP, Gutierrez PM, Blacker D. Anxiety measures and their relationship to adolescent suicidal ideation and behavior. J Anxiety Disord. 2002;16:11–32.CrossRef
Metadata
Title
Suicidal ideation in primary care patients suffering from panic disorder with or without agoraphobia
Authors
Tobias Teismann
Karoline Lukaschek
Thomas S. Hiller
Jörg Breitbart
Christian Brettschneider
Ulrike Schumacher
Jürgen Margraf
Jochen Gensichen
the Jena Paradies Study Group
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2018
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-018-1894-5

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