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

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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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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: Sareen, Jitender
Cox, Brian J.
Afifi, Tracie O.
Asmundson, Gordon J. G.
Stein, Murray B.
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
Health Sciences › Medicine › Psychiatry and Mental health › 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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Anxiety Disorders and Risk for Suicidal Ideation and Suicide Attempts: A Population-Based Longitudinal Study of Adults

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