Panic disorder and suicidality: is comorbidity with depression the key?

Gabriel Diaconu, Gustavo Turecki
Journal of Affective Disorders 2007, 104 (1): 203-9

BACKGROUND: The relation between panic disorder and suicidal behavior has been surrounded by perennial controversy. A significant number of reports suggest that PD is associated with suicidal behavior. Alternatively, it has been proposed that comorbid depression may account for the increased suicidality identified in this population.

METHOD: A total of n=474 consecutive psychiatric outpatient subjects were assessed for Axes I and II psychopathology and personality traits, as well as suicidal behavior, using structured interviews.

RESULTS: Approximately half of the sample (n=250) reported suicidal ideation, either lifetime or during the 6 months prior to evaluation. In total, 200 subjects reported a history of suicide attempts. When comorbidity with depressive disorders (DD) was not taken into account, patients with Panic Disorder (PD) did not differ from those with a primary diagnosis of depressive disorder in terms of age, current or lifetime suicide ideation or number of suicide attempts. After separating the group characterized by PD comorbid with DD, PD only subjects had significantly lower number of suicide attempts compared to either DD (p<0.01) or comorbid PD-DD (p<0.05). Similar levels of SI were noted between PD, DD and PD-DD, both current and lifetime. Suicide attempters with PD, DD or both did not differ in terms of suicide intent or lethality. They were also similar on impulsivity, aggressive behavior and state-trait anxiety measures.

LIMITATIONS: Cross-sectional design, the limited sample size in the PD only group, retrospectively collected data with the possibility of recall bias.

CONCLUSIONS: In this clinical outpatient sample, the association between panic disorder and suicidal behavior was primarily explained by comorbidity with depressive disorders. No differences were observed between different groups for measures of severity of the suicidal behavior. Physicians should be aware of these associations when assessing adults with panic disorder for suicidality.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"