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Anxiety Disorders Associated With Suicidal Ideation and Suicide Attempts in the National Comorbidity Survey

Sareen, Jitender MD*; Houlahan, Tanya MD*; Cox, Brian J. PhD*; Asmundson, Gordon J. G. PhD

The Journal of Nervous and Mental Disease: July 2005 - Volume 193 - Issue 7 - p 450-454
doi: 10.1097/01.nmd.0000168263.89652.6b
Original Articles

This study examined the relationship between anxiety disorders and suicidal ideation or suicide attempts in a nationally representative sample (N = 5877; age, 15–54; response rate, 82.4%). A modified version of the Composite International Diagnostic Interview was used to make DSM-III-R mental disorder diagnoses. Two multivariate logistic regression analyses were performed with suicidal ideation (N = 754) and suicide attempts (N = 259) as dependent variables. In each regression, the independent variables entered were lifetime social phobia, panic disorder, agoraphobia, generalized anxiety disorder, simple phobia, and posttraumatic stress disorder (PTSD). Covariates in the analyses were sociodemographics, lifetime mood disorders, substance use disorders, nonaffective psychosis, antisocial personality disorder, and presence of three or more lifetime DSM-III-R diagnoses. PTSD was significantly associated with suicidal ideation (adjusted odds ratio = 2.79; p < 0.01) and suicide attempts (adjusted odds ratio = 2.67; p < 0.01). None of the other anxiety disorders were significantly associated with suicidal ideation or attempts. The robust association between PTSD and suicide attempts has important implications for psychiatric assessment of suicidal behavior. Future research is required to investigate the mechanisms underlying the relationship between PTSD and suicidal behavior.

*Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada; and †Anxiety and Illness Behaviors Laboratory, University of Regina, Regina, Saskatchewan, Canada.

Supported by New Emerging Team Grant PTS-63186 from the Canadian Institutes of Health Research (CIHR) Institute of Neurosciences, Mental Health and Addiction, a CIHR operating grant awarded to Dr. Cox, and a Manitoba Research Council Establishment Grant awarded to Dr. Sareen. Dr. Asmundson is supported by a CIHR Investigator award. The NCS was supported by grants from the National Institute of Mental Health, the National Institute of Drug and Alcohol Abuse, and the W. T. Grant Foundation.

Poster presentation at the Anxiety Disorders Association of America Annual Conference in Miami, Florida, March 11–14, 2004.

Send reprint requests to: Jitender Sareen, MD, PZ-430 771 Bannatyne Ave., Winnipeg, MB, Canada, R3E 3N4.

© 2005 Lippincott Williams & Wilkins, Inc.