Are comorbid anxiety disorders a risk factor for suicide attempts in patients with mood disorders? A two-year prospective study
Open accessAbstract
BACKGROUND: Comorbid anxiety disorders have been considered a risk factor for suicidal behavior in patients with mood disorders, although results are controversial. The aim of this two-year prospective study was to determine if lifetime and current comorbid anxiety disorders at baseline were risk factors for suicide attempts during the two-year follow-up. METHODS: We evaluated 667 patients with mood disorders (504 with major depression and 167 with bipolar disorder) divided in two groups: those with lifetime comorbid anxiety disorders (n=229) and those without (n=438). Assessments were performed at baseline and at 3, 12, and 24 months. Kaplan-Meier survival analysis and log-rank test were used to evaluate the relationship between anxiety disorders and suicide attempts. Cox proportional hazard regression was performed to investigate clinical and demographic variables that were associated with suicide attempts during follow-up. RESULTS: Of the initial sample of 667 patients, 480 had all three follow-up interviews. During the follow-up, 63 patients (13.1%) attempted suicide at least once. There was no significant difference in survival curves for patients with and without comorbid anxiety disorders (log-rank test=0.269; P=0.604). Female gender (HR=3.66, P=0.001), previous suicide attempts (HR=3.27, P=0.001) and higher scores in the Buss-Durkee Hostility Inventory (HR=1.05, P≤0.001) were associated with future suicide attempts. CONCLUSIONS: Our results suggest that comorbid anxiety disorders were not risk factors for suicide attempts. Further studies were needed to determine the role of anxiety disorders as risk factors for suicide attempts.
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Results of prospective studies on the effect of anxiety disorders on suicidal ideation are mixed, with some confirming and some falsifying the effect.
“The role of anxiety in the development of SI is less clear, since results of prospective studies are mixed – some confirmed and some falsified the effect of anxiety disorders on SI (Abreu et al., 2018; Bolton et al., 2010; Oquendo et al., 2004).”
From Modelling suicide ideation from beep to beep: application of network analysis to ecological momentary assessment data (2019) · cites this paper as Abreu et al., 2018
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- Authors
- Abreu, L. N., Oquendo, M. A., Galfavy, H., Burke, A., Grunebaum, M. F., Sher, L., Sullivan, G. M., Sublette, M. E., Mann, J., & Lafer, B.
- Affiliations
- Universidade de São Paulo (BR)
- New York State Psychiatric Institute (US)
- James J. Peters VA Medical Center (US)
- Venue
- European Psychiatry
- Publisher
- Cambridge University Press (CUP)
- Published
- 2018-01
- Volume
- 47
- Pages
- 19-24
- ISSN
- 0924-9338 (ISSN-L)
- 1778-3585
- PMC
- PMC5766396
- OpenAlex
- W2759441395
- Cited by
- 34
- References
- 39
- Citations by year
- 2026: 3 · 2024: 5 · 2023: 6 · 2022: 3 · 2021: 4 · 2020: 7 · 2019: 4 · 2018: 2
- FWCI
- 4.40
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Conselho Nacional de Desenvolvimento Científico e Tecnológico
- National Institute of Mental Health (MH 62185, P50MH090964, R01MH059710, R01MH59710, P50-MH62185, MH 59710, MH090964, P50MH062185, NIMH P50)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- comorbid anxiety disorders, suicide attempts, mood disorders, major depressive disorder, bipolar disorder, risk factors, hostility, previous suicide attempts, female gender
- MeSH terms
- Adult, Anxiety Disorders, Bipolar Disorder, Major Depressive Disorder, Female, Hostility, Humans, Male, Prospective Studies, Risk Factors, Suicide, Attempted, Time Factors, Mood Disorders, Suicidal Ideation
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