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. 2018 Jan:47:19-24.
doi: 10.1016/j.eurpsy.2017.09.005. Epub 2017 Sep 29.

Are comorbid anxiety disorders a risk factor for suicide attempts in patients with mood disorders? A two-year prospective study

L N Abreu  1 , M A Oquendo  2 , H Galfavy  2 , A Burke  2 , M F Grunebaum  2 , L Sher  3 , G M Sullivan  2 , M E Sublette  2 , J Mann  2 , B Lafer  4
Affiliations

Are comorbid anxiety disorders a risk factor for suicide attempts in patients with mood disorders? A two-year prospective study

L N Abreu et al. Eur Psychiatry. 2018 Jan.

Abstract

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.

Keywords: Anxiety; Bipolar; Comorbidity; Major depression; Suicide; Suicide attempts.

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Conflict of interest statement

Disclosures

Dr. Abreu received editorial fees from Cristalia and Supera Laboratories, Brazil Dr. Sullivan reports employ/stockholder from Tonix Pharmaceuticals, Inc.

Dr. Burke receives royalties for the commercial use of the Columbia-Suicide Severity Rating Scale

Dr. Galfalvy reports family owns from Illumina Inc

Dr. Lafer reports grants from CNPq (Conselho Nacional de Desenvolvimento Cientifico e Tecnologico)

Dr. Mann receives royalties for the commercial use of the Columbia-Suicide Severity Rating Scale

Dr. Oquendo receives royalties for the commercial use of the Columbia-Suicide Severity Rating Scale and Dr. Oquendo's family owns stock in Bristol Myers Squibb.

Figures

Figure 1
Figure 1
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