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Cited by 824Suicide and Self-Harm StudiesMental Health Treatment and AccessAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Anxiety Disorders and Risk for Suicidal Ideation and Suicide Attempts: A Population-Based Longitudinal Study of Adults

Sareen, Jitender, Cox, Brian J., Afifi, Tracie O., de Graaf, Ron, Asmundson, Gordon J. G., ten Have, Margreet, Stein, Murray B.·2005·Archives of General Psychiatry
DOI 10.1001/archpsyc.62.11.1249
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Abstract

CONTEXT: Controversy exists whether anxiety disorders are independently associated (ie, after adjusting for comorbid mental disorders) with suicidal ideation and suicide attempts. OBJECTIVE: To examine whether anxiety disorders are risk factors for suicidal ideation and suicide attempts in a large population-based longitudinal study. METHODS: Data come from the Netherlands Mental Health Survey and Incidence Study, a prospective population-based survey with a baseline and 2 follow-up assessments over a 3-year period. The Composite International Diagnostic Interview was used to assess DSM-III-R mental disorders. Lifetime diagnoses of anxiety disorders (social phobia, simple phobia, generalized anxiety disorder, panic disorder, agoraphobia, obsessive-compulsive disorder) were assessed at baseline. Multiple logistic regression analyses were used to examine whether anxiety disorders were associated with suicidal ideation and attempts at baseline (n = 7076) and whether anxiety disorders were risk factors for subsequent onset of suicidal ideation and attempts (n = 4796). RESULTS: After adjusting for sociodemographic factors and all other mental disorders assessed in the survey, baseline presence of any anxiety disorder was significantly associated with suicidal ideation and suicide attempts in both the cross-sectional analysis (adjusted odds ratio for suicidal ideation, 2.29; 95% confidence interval, 1.85-2.82; adjusted odds ratio for suicidal attempts, 2.48; 95% confidence interval, 1.70-3.62) and longitudinal analysis (adjusted odds ratio for suicidal ideation, 2.32; 95% confidence interval, 1.31-4.11; adjusted odds ratio for suicide attempts, 3.64; 95% confidence interval, 1.70-7.83). Further analyses demonstrated that the presence of any anxiety disorder in combination with a mood disorder was associated with a higher likelihood of suicide attempts in comparison with a mood disorder alone. CONCLUSIONS: This is the first study to demonstrate that a preexisting anxiety disorder is an independent risk factor for subsequent onset of suicidal ideation and attempts. Moreover, the data clearly demonstrate that comorbid anxiety disorders amplify the risk of suicide attempts in persons with mood disorders. Clinicians and policymakers need to be aware of these findings, and further research is required to delineate whether treatment of anxiety disorders reduces the risk of subsequent suicidal behavior.

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  • SAD is associated with increased reports of suicidal ideation and attempts when compared to other anxiety disorders.

    “SAD is further associated with increased reports of suicidal ideation (SI) and attempts when compared to other anxiety disorders (Sareen et al., 2005; Cougle et al., 2009; De La Vega et al., 2018).”

    From Can dialectical behavior therapy skills group treat social anxiety disorder? A brief integrative review (2024) · cites this paper as Sareen et al., 2005

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Authors
Sareen, J., Cox, B. J., Afifi, T. O., de Graaf, R., Asmundson, G. J. G., ten Have, M., & Stein, M. B.
Affiliations
Utrecht University (NL)
ORCID
Venue
Archives of General Psychiatry
Publisher
American Medical Association (AMA)
Published
2005-11-01
Volume
62
Issue
11
Pages
1249
ISSN
0003-990X (ISSN-L)
DOI
10.1001/archpsyc.62.11.1249
OpenAlex
W2162326286
Cited by
824
References
63
Citations by year
2026: 22 · 2025: 26 · 2024: 50 · 2023: 41 · 2022: 39 · 2021: 43 · 2020: 54 · 2019: 46 · 2018: 48 · 2017: 33 · 2016: 57 · 2015: 46 · 2014: 46 · 2013: 43 · 2012: 43
FWCI
27.48
Type
journal article
Language
en
Open access
closed
Locations
  • Archives of General Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
anxiety disorders, suicidal ideation, suicide attempts, suicide risk factors, comorbidities, mood disorders, generalized anxiety disorder, panic disorder, agoraphobia, obsessive-compulsive disorder, social anxiety disorder, specific phobia
MeSH terms
Adolescent, Adult, Age Factors, Anxiety Disorders, Mental Disorders, Cross-Sectional Studies, Data Collection, Female, Follow-Up Studies, Humans, Longitudinal Studies, Male, Middle Aged, Netherlands, Prospective Studies, Risk Factors, Suicide, Suicide, Attempted, Comorbidity, Incidence, Mood Disorders

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