Suicide Risk in Outpatients with Specific Mood and Anxiety Disorders

Crisis ◽  
2003 ◽  
Vol 24 (3) ◽  
pp. 105-112 ◽  
Author(s):  
Andrea P. Chioqueta ◽  
Tore C. Stiles
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Depressive Episode ◽  
Suicide Risk ◽  
Depressive Disorders ◽  
Major Depressive Episode ◽  
Suicide Ideation ◽  
Anxiety Symptoms ◽  
Major Depressive ◽  
Special Relevance

Summary: The present study examined the relationships between specific anxiety, mood disorders, levels of hopelessness, and suicide ideation. The sample consisted of 606 outpatients recruited from several psychiatric settings. It was found that dysthymia was significantly associated with hopelessness. Patients presenting major depressive episode with higher anxiety symptoms had significantly increased scores on the hopelessness scale. Major depressive episode and bipolar disorder, but not dysthymia, were significantly associated with higher levels of suicide ideation. Increased levels of anxiety symptoms in patients with dysthymia were associated with increased levels of suicide ideation, while increased depressive symptoms in patients with specific phobia and generalized anxiety disorder were associated with significantly lower levels of suicide ideation. The findings suggest that depressive disorders, but not anxiety disorders, constitute risk for suicide. Moreover, the differentiation between a depressive and an anxiety disorder as the principal diagnosis, as well as the assessment of anxiety-level symptoms in patients with major depressive episode and dysthymia, seems of special relevance when assessing suicide risk.

Differences in Suicide Risk Severity Among Suicidal Youth With Anxiety Disorders

Crisis ◽  
2019 ◽  
Vol 40 (5) ◽  
pp. 333-339 ◽  
Author(s):  
Joanna Herres ◽  
Annie Shearer ◽  
Tamar Kodish ◽  
Barunie Kim ◽  
Shirley B. Wang ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Suicidal Ideation ◽  
Social Anxiety ◽  
Anxiety Disorders ◽  
Suicide Risk ◽  
Suicide Ideation ◽  
Self Report ◽  
Health Concern ◽  
Future Research ◽  
Major Depressive

Abstract. Background: Adolescent suicidality is a growing public health concern. Although evidence supports a link between anxiety and suicidality, little is known about risk associated with specific anxiety disorders. Aims: This study examined the prevalence of anxiety disorders in a sample of adolescents with depression and suicidal ideation and the associations between specific anxiety disorders and suicide ideation severity and attempt history. Method: The sample consisted of 115 adolescents ( Mage= 14.96 years; 55.8% African American) entering a clinical trial for suicidal ideation and depressive symptoms. Prior to treatment, adolescents completed self-report and interview measures. Results: In all, 48% of the sample met criteria for an anxiety disorder, 22% met criteria for social anxiety disorder (SAD), and 40% met criteria for major depressive disorder (MDD). SAD was uniquely associated with more severe suicidal ideation. Limitations: Findings may not generalize to all suicidal adolescents, and non-measured variables may account for the observed relationships. Conclusion: Future research should examine whether targeting social anxiety would improve treatment response for suicidal adolescents.

The Comorbidity of Anxiety and Depression

1997 ◽  
Vol 31 (5) ◽  
pp. 700-703 ◽  
Author(s):  
James Rodney ◽  
Nigel Prior ◽  
Betty Cooper ◽  
Mike Theodoros ◽  
Joanne Browning ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Major Depression ◽  
Anxiety Disorders ◽  
Depressive Episode ◽  
Major Depressive Episode ◽  
Study Cohort ◽  
Depression And Anxiety ◽  
Major Depressive ◽  
Comorbid Anxiety ◽  
Significant Difference

Objective: This study explored the effect of comohid anxiety disorders in patients admitted to an inpatient specialist Mood Disorders Unit for the treatment of a primary major depressive episode. Method: Subjects were assessed on admission and discharge. DSM-Ill-R diagnoses for major depression and anxiety disorders were established using CIDI-Auto; cornorbid anxiety disorders were coexistent in time with the major depression, with both conditions meeting diagnostic criteria at the time of assessment. Severity of illness was assessed using the Hamilton DepressiodMelancholia Scale, the revised Hamilton Anxiety Scale and the revised Beck Depression Inventory. Results: For the analysis, the study cohort was divided into three groups: depression alone (n = 33), one comorbid anxiety disorder (n = 15), and two or more comorbid anxiety disorders (n = 24). No particular anxiety disorder predominated. Interestingly, the presence or absence of comorbid anxiety with severe major depression made no significant difference to treatment choice or outcome results. Specifically, there was no significant difference between the three groups in the utilisation of electroconvulsive therapy and pharmacotherapy (including antidepres-sants, benzodiazepines and neuroleptics); all subjects improved significantly on both depression and anxiety ratings, and length of inpatient stay did not vary significantly between the three groups. Conclusions: The existence of comorbid anxiety disorders in those patients who presented for treatment of a primary major depressive episode did not significantly effect choice of treatment or treatment outcome, suggesting that there is a close interrelationship between the two conditions.

scholarly journals The influence of the comorbidity between depression and alcohol use disorder on suicidal behaviors in the São Paulo Epidemiologic Catchment Area Study, Brazil

2010 ◽  
Vol 32 (4) ◽  
pp. 396-408 ◽  
Author(s):  
Bruno Mendonça Coêlho ◽  
Laura Helena Andrade ◽  
Francisco Bevilacqua Guarniero ◽  
Yuan-Pang Wang
Keyword(s):  
Substance Use ◽  
Alcohol Use ◽  
Substance Use Disorders ◽  
Depressive Episode ◽  
Depressive Disorders ◽  
Major Depressive Episode ◽  
Alcohol Use Disorders ◽  
Major Depressive ◽  
And Behaviors ◽  
And Gender

OBJECTIVE: To investigate in a community sample the association of suicide-related cognitions and behaviors ("thoughts of death", "desire for death", "suicidal thoughts", and "suicidal attempts") with the comorbidity of depressive disorders (major depressive episode or dysthymia) and alcohol or substance use disorders. METHOD: The sample was 1464 subjects interviewed in their homes using the Composite International Diagnostic Interview to generate DSM-III-R diagnosis. Descriptive statistics depicted the prevalence of suicide-related cognitions and behaviors by socio-demographic variables and diagnoses considered (major depressive episode, dysthymia, alcohol or substance use disorders). We performed a multivariate logistic regression analysis to estimate the effect of comorbid major depressive episode/dysthymia and alcohol or substance use disorders on each of the suicide-related cognitions and behaviors. RESULTS: The presence of major depressive episode and dysthymia was significantly associated with suicide-related cognitions and behaviors. In the regression models, suicide-related cognitions and behaviors were predicted by major depressive episode (OR = range 2.3-9.2) and dysthymia (OR = range 5.1-32.6), even in the presence of alcohol use disorders (OR = range 2.3-4.0) or alcohol or substance use disorders (OR = range 2.7-2.8). The interaction effect was observed between major depressive episode and alcohol use disorders, as well as between dysthymia and gender. Substance use disorders were excluded from most of the models. CONCLUSION: Presence of major depressive episode and dysthymia influences suicide-related cognitions and behaviors, independently of the presence of alcohol or substance use disorders. However, alcohol use disorders and gender interact with depressive disorders, displaying a differential effect on suicide-related cognitions and behaviors.

Procedural validity of the computerized version of the Composite International Diagnostic Interview (CIDI-Auto) in the anxiety disorders

1995 ◽  
Vol 25 (6) ◽  
pp. 1269-1280 ◽  
Author(s):  
Lorna Peters ◽  
Gavin Andrews
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Major Depressive Episode ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Obsessive Compulsive ◽  
Major Depressive ◽  
Lower Range ◽  
Compulsive Disorder ◽  
Level Of Agreement

SynopsisThe procedural validity of the computerized version of the Composite International Diagnostic Interview (CIDI-Auto) was examined against the consensus diagnoses of two clinicians for six anxiety disorders (agoraphobia, panic disorder (±agoraphobia), social phobia, simple phobia, obsessive compulsive disorder (OCD), generalized anxiety disorder (GAD) and major depressive episode (MDE)). Clinicians had available to them all data obtained over a 2- to 10-month period. Subjects were 98 patients accepted for treatment at an Anxiety Disorders Clinic, thus, all subjects had at least one of the diagnoses being examined. While the CIDI-Auto detected 88·2% of the clinician diagnoses, it identified twice as many diagnoses as did the clinicians. The sensitivity of the CIDI-Auto was above 0·85 except for GAD, which had a sensitivity of 0·29. The specificity of the CIDI-Auto was lower (range: 0·47–0·99). The agreement between the CIDI-Auto and the clinician diagnoses, as measured by intraclass kappas, ranged from poor (k = 0·02; GAD) to excellent (k = 0·81; OCD), with a fair level of agreement overall (k = 0·40). Canonical correlation analysis suggested that the discrepancies between the CIDI-Auto and clinicians were not due to different diagnostic distinctions being made. It is suggested that the CIDI-Auto may have a lower threshold for diagnosing anxiety disorders than do experienced clinicians. It is concluded that, in a sample where all subjects have at least one anxiety disorder diagnosis, the CIDI-Auto has acceptable validity.

Emotion-modulated startle in anxiety disorders is blunted by co-morbid depressive episodes

2010 ◽  
Vol 41 (1) ◽  
pp. 129-139 ◽  
Author(s):  
A. Taylor-Clift ◽  
B. H. Morris ◽  
J. Rottenberg ◽  
M. Kovacs
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Depressive Episode ◽  
Emotional Reactivity ◽  
Depressive Disorders ◽  
Late Onset ◽  
Response Patterns ◽  
Emotional Responding ◽  
Depressive Episodes ◽  
A Current

BackgroundWhile anxiety has been associated with exaggerated emotional reactivity, depression has been associated with blunted, or context insensitive, emotional responding. Although anxiety and depressive disorders are frequently co-morbid, surprisingly little is known about emotional reactivity when the two disorders co-occur.MethodWe utilized the emotion-modulated startle (EMS) paradigm to examine the effects of a concurrent depressive episode on emotional reactivity in young adults with anxiety disorders. Using an archival dataset from a multi-disciplinary project on risk factors in childhood-onset depression, we examined eye-blink startle reactions to late-onset auditory startle probes while participants viewed pictures with affectively pleasant, unpleasant and neutral content. EMS response patterns were analyzed in 33 individuals with a current anxiety (but no depressive) disorder, 24 individuals with a current anxiety disorder and co-morbid depressive episode and 96 healthy controls.ResultsControl participants and those with a current anxiety disorder (but no depression) displayed normative linearity in startle responses, including potentiation by unpleasant pictures. By contrast, individuals with concurrent anxiety and depression displayed blunted EMS.ConclusionsAn anxiety disorder concurrent with a depressive episode is associated with reactivity that more closely resembles the pattern of emotional responding that is typical of depression (i.e. context insensitive) rather than the pattern that is typical for anxiety (i.e. exaggerated).

Is major depressive episode related to anxiety disorders in anorexics and bulimics?

2006 ◽  
Vol 47 (2) ◽  
pp. 91-98 ◽  
Author(s):  
Nathalie T. Godart ◽  
Fabienne Perdereau ◽  
Florence Curt ◽  
Zoé Rein ◽  
François Lang ◽  
...  
Keyword(s):  
Anxiety Disorders ◽  
Depressive Episode ◽  
Major Depressive Episode ◽  
Major Depressive

Detection and Prevalence of Depressive Disorders in Primary Care Settings in Hungary

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
P. Torzsa ◽  
X. Gonda ◽  
N. Szokontor ◽  
B. Sebestyen ◽  
G. Faludi ◽  
...  
Keyword(s):  
Primary Care ◽  
Beck Depression Inventory ◽  
Depressive Episode ◽  
Depressive Disorders ◽  
Major Depressive Episode ◽  
Care Service ◽  
Health Care Service ◽  
Major Depressive ◽  
Current Prevalence ◽  
Dsm Iv

Background:Although depressive disorders are common conditions in primary health care service, and many depressed patients consult their general practitioners, GPs have some difficulties in the detection and correct diagnosis of depression. Unrecognized and untreated depression causes great health and economic burden and also contributes to significant suffering, therefore the correct recognition of affective disorder in GP settings is an important healthcare target. The aim of our study was to assess the prevalence of depressive disorders in general practices in Hungary and also to assess the sensitivity and specificity of different depression screening instruments.Method:In the present study the current prevalence of DSM-IV depressive disorders were surveyed among 984 primary care attendees in 6 GP practices in Hungary, using the Beck Depression Inventory and the PRIME-MD screening instrument.Results:The current prevalence rate of any PRIME-MD DSM-IV depressive disorders, including symptomatic major depressive episode, were 18.5% and 7.3% respectively. Beck Depression Inventory identified any current depressive disorders with 95% sensitivity and 56% specificity and the same figures for current symptomatic major depressive episode were 83% and 23%, respectively.Discussion:Our results are similar to those reported previously from Hungary and from other countries. The findings also indicate that the Beck Depression Inventory and PRIME-MD can help in detecting depressive disorders in primary care.

Treatment resistance in bipolar disorder

2011 ◽  
Vol 26 (S2) ◽  
pp. 2025-2025
Author(s):  
Z. Rihmer
Keyword(s):  
Bipolar Disorder ◽  
Major Depression ◽  
Depressive Episode ◽  
Depressive Disorders ◽  
Major Depressive Episode ◽  
Treatment Resistance ◽  
Mood Stabilizers ◽  
Common Source ◽  
Major Depressive ◽  
Unipolar Major Depression

Antidepressant-resistant major depression (AD-RD) is a great challenge for the treating clinician. The most widely accepted definition of AD-RD refers that the depressed patient does not show a clinically significant response after at least two adequate trials of different classes of antidepressants. In spite of the fact that there are several causes of AD-RD in general, there is increasing evidence that one of the most common sources of it is the unrecognized bipolar nature of the “unipolar” major depressive episode, when the patients receive antidepressant monotherapy - unprotected by mood stabilizers/atypical antipsychotics. While it is well documented that the optimal clinical response to antidepressants is much rare in bipolar I and II than in unipolar major depression, only the most recent clinical studies have focused on the boundaries between treatment-resistant unipolar major depressive disorder and bipolar disorder. The most widely noted conclusion of the prior studies on AD-RD is that if noncompliance, hypothyreosis, use of “depressiogenic” drugs and pharmacokinetic causes etc, can be excluded, antidepressant-resistance reflects the heterogeneity of depressive disorders and different subgroups of depressed patients respond (or do not respond) to different drugs. However, current psychopathological research on the complex relationship between unipolar depression and bipolar disorders show that the most common source of antidepressant-resistance in DSM-IV diagnosed unipolar major depression is the result of the subthreshold or unrecognized bipolar nature of the depressive episode and antidepressant-induced (hypo)manic switches, antidepressant-resistance and “suicide-inducing” potential of antidepressants seem to be related to the underlying bipolarity of the major depressive episode.

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