Citation

Masdrakis VG, Konstantopoulou S, Baldwin DS. Hum. Psychopharmacol. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, John Wiley and Sons)

DOI

10.1002/hup.2879

PMID

37358233

Abstract

Suicide is a significant public health issue. Annually, approximately 800,000--1,000,000 people die by suicide: for each one, there are at least 20 others who attempt it. Traditionally, anxiety disorders were considered to be of little importance in suicide. Data indicating that patients with anxiety disorders can die by suicide may surprise clinicians even today--and certainly did during the 1980s when the first relevant reports emerged. This may be because anxious patients often express concerns about their physical health, or--especially in patients with panic attacks--fear imminent death and strive to avoid it through visiting emergency outpatient clinics, persistently seeking reassurance from medical professionals, and/or adopting dysfunctional safety-seeking behaviors (De La Vega et al., 2018).

Khan et al. (2002), using the United States Food and Drug Administration database, assessed suicide risk among patients participating in clinical trials evaluating novel medications for anxiety disorders, obsessive-compulsive disorder and post-traumatic disorder. They found that suicide risk among patients was high regardless of the type of disorder, and overall was higher than in the general population, by a factor of 10 or more. They considered this finding unexpected, especially since patients participating in clinical trials for new medications are selected strictly, so that suicide risk is anticipated to be minimal. Kanwar et al. (2013) reviewed 42 observational studies involving 309,974 patients with anxiety and anxiety-related disorders. Compared to those without anxiety, anxious patients were more likely to have suicidal ideation (OR = 2.89, 95% CI: 2.09, 4.00), attempted suicide (OR = 2.47, 95% CI: 1.96, 3.10), complete suicide (OR = 3.34, 95% CI: 2.13, 5.25), or have any suicidal behaviors (OR = 2.85, 95% CI: 2.35, 3.46): all anxiety disorders, but not obsessive-compulsive disorder, were associated with increased suicide risk.

However, regarding obsessive-compulsive disorder (OCD), more recent analyses show that around one out of every 10 patients attempts suicide during their life; about one-third have current suicidal ideation; and about half have had suicidal ideation in the past. Concerning adult separation anxiety disorder, it was significantly more frequent among outpatients with other anxiety or mood disorders who had suicidal thoughts compared to those without such thoughts...

Language: en

Keywords

prevention; suicidality; anxiety disorders; psychopathology