Richard C Oude Voshaar1, Date C van der Veen1, Isabelle Hunt2, Nav Kapur2. 1. University of Groningen, University Medical Center Groningen, Interdisciplinary Center for Psychopathology of Emotion regulation (ICPE), Groningen, The Netherlands. 2. Centre for Suicide Prevention, University of Manchester, Manchester, UK.
Abstract
OBJECTIVE: Comorbid anxiety in depression increases the risk of suicidal ideation and behavior, although data on death by suicide are scarce. We compared characteristics of depressed elderly patients with and without anxiety disorders who died by suicide. METHODS: From a 16-year clinical survey of all suicides in the UK (n = 25,128), we identified 1909 cases aged ≥60 years with a primary diagnosis of depression and no comorbidity other than anxiety disorders. Clinical characteristics of cases with (n = 333, 17.4%) and without (n = 1576) comorbid anxiety disorders were compared by logistic regression adjusted for demographic differences. RESULTS: Compared with cases without comorbid anxiety disorders, cases with comorbid anxiety disorders were more likely to have a duration of illness over 1 year (OR(1-5 years) = 1.4 [95% CI: 1.0-1.9], p = 0.061; OR(≥5 years) = 1.4 [95% CI: 1.6-2.8], p < 0.001), were more frequently prescribed psychotropic drugs other than antidepressants, lithium, and antipsychotics (OR = 2.1 [95% CI: 1.6-2.7], p < 0.001) and were more distressed during their last contact with services (OR = 1.3 [95% CI: 1.0-1.7], p = 0.037). In contrast, clinicians estimated the immediate and long-term suicidal risks lower in those with comorbid anxiety disorders (OR = 0.6 [95% CI: 0.3-0.9], p = 0.011 and OR = 0.7 [95% CI: 0.6-1.0], p = 0.028, respectively). CONCLUSION: Among depressed suicide cases, a comorbid anxiety disorder was identified in one out of six cases and associated with a higher prevalence of several suicide risk factors. This is important, as the detection of anxiety disorders comorbid to depression seems rather low and even when recognized clinicians rated such individuals as at low suicide risk.
OBJECTIVE: Comorbid anxiety in depression increases the risk of suicidal ideation and behavior, although data on death by suicide are scarce. We compared characteristics of depressed elderly patients with and without anxiety disorders who died by suicide. METHODS: From a 16-year clinical survey of all suicides in the UK (n = 25,128), we identified 1909 cases aged ≥60 years with a primary diagnosis of depression and no comorbidity other than anxiety disorders. Clinical characteristics of cases with (n = 333, 17.4%) and without (n = 1576) comorbid anxiety disorders were compared by logistic regression adjusted for demographic differences. RESULTS: Compared with cases without comorbid anxiety disorders, cases with comorbid anxiety disorders were more likely to have a duration of illness over 1 year (OR(1-5 years) = 1.4 [95% CI: 1.0-1.9], p = 0.061; OR(≥5 years) = 1.4 [95% CI: 1.6-2.8], p < 0.001), were more frequently prescribed psychotropic drugs other than antidepressants, lithium, and antipsychotics (OR = 2.1 [95% CI: 1.6-2.7], p < 0.001) and were more distressed during their last contact with services (OR = 1.3 [95% CI: 1.0-1.7], p = 0.037). In contrast, clinicians estimated the immediate and long-term suicidal risks lower in those with comorbid anxiety disorders (OR = 0.6 [95% CI: 0.3-0.9], p = 0.011 and OR = 0.7 [95% CI: 0.6-1.0], p = 0.028, respectively). CONCLUSION: Among depressed suicide cases, a comorbid anxiety disorder was identified in one out of six cases and associated with a higher prevalence of several suicide risk factors. This is important, as the detection of anxiety disorders comorbid to depression seems rather low and even when recognized clinicians rated such individuals as at low suicide risk.
Authors: Sergio L Blay; Gerda G Fillenbaum; Marcelo F Mello; Maria I Quintana; Jair J Mari; Rodrigo A Bressan; Sergio B Andreoli Journal: J Affect Disord Date: 2018-02-17 Impact factor: 4.839
Authors: Jessamine Tsan-Hsiang Chen; Viviana M Wuthrich; Ronald M Rapee; Brian Draper; Henry Brodaty; Henry Cutler; Lee-Fay Low; Andrew Georgiou; Carly Johnco; Michael Jones; Denise Meuldijk; Andrew Partington Journal: PLoS One Date: 2022-06-27 Impact factor: 3.752
Authors: Marsal Sanches; Linh K Nguyen; Tong Han Chung; Paul Nestadt; Holly C Wilcox; William H Coryell; Jair C Soares; Sudhakar Selvaraj Journal: J Affect Disord Date: 2022-03-22 Impact factor: 6.533
Authors: Stefan Wiktorsson; Therese Rydberg Sterner; Madeleine Mellqvist Fässberg; Ingmar Skoog; Anne Ingeborg Berg; Paul Duberstein; Kimberly Van Orden; Margda Waern Journal: Int J Environ Res Public Health Date: 2018-01-16 Impact factor: 3.390