Panic Disorder and Suicidal Behavior

Crisis ◽  
2011 ◽  
Vol 32 (3) ◽  
pp. 169-172 ◽  
Author(s):  
Tamas Zonda ◽  
Gabriella Nagy ◽  
David Lester

Background: Previous research has suggested that patients with panic disorder but no comorbid disorder are not at greater risk for suicidal behavior. Aims: The present study followed up patients with panic disorder in order to assess the frequency of their suicidal behavior. Methods: A sample of 281 outpatients with panic disorder, but without a comorbid psychiatric disorder, was followed up for an average of 5 years. The patients were given 6–8 weeks of cognitive therapy, and 65% were prescribed SSRIs. Results: At the time of first admission, 5 patients (1.7%) reported a previous (lifetime) suicide attempt, and 53 patients (18.2%) reported previous (lifetime) suicidal ideation (both thoughts and plans), not greatly different from the Hungarian population in general. During the follow-up period, no patient committed suicide, 2 patients attempted suicide (0.7%), and 4 patients (1.4%) reported suicidal ideation. Conclusions: This study indicates that people with panic disorders without comorbid disorders have no higher suicidal risk than the general population in Hungary. After treatment with cognitive therapy and SSRIs, 38.5% were symptom-free, and only 7.8% required continued close therapeutic contact after the follow-up period.

Crisis ◽  
2014 ◽  
Vol 35 (6) ◽  
pp. 406-414 ◽  
Author(s):  
Raimondo Maria Pavarin ◽  
Angelo Fioritti ◽  
Francesca Fontana ◽  
Silvia Marani ◽  
Alessandra Paparelli ◽  
...  

Background: The international literature reports that for every completed suicide there are between 8 and 22 visits to an Emergency Department (ED) for attempted suicide/suicidal behavior. Aims: To describe the characteristics of admission to emergency departments (EDs) for suicide-related presenting complaints in the metropolitan area of Bologna; to estimate the risk for all-cause mortality and for suicide; to identify the profiles of subjects most at risk. Method: Follow-up of patients admitted to the EDs of the metropolitan area of Bologna between January 2004 and December 2010 for attempted suicide. A Cox model was used to evaluate the association between sociodemographic variables and the general mortality risk. Results: We identified 505 cases of attempted suicide, which were more frequent for female subjects, over the weekend, and at night (8:00 p.m./8:00 a.m.). The most used suicide methods were psychotropic drugs, sharp or blunt objects, and jumping from high places. In this cohort, 3.6% of subjects completed suicide (4.5% of males vs. 2.9% of females), 2.3% within 1 year of the start of follow-up. The most common causes of death were drug use and hanging. In the multivariate analysis, those who used illicit drugs 24 hr prior to admission to the ED (hazard ratio [HR] = 3.46, 95% CI = 1.23–9.73) and patients who refused the treatment (HR = 6.74, 95% CI = 1.86–24.40) showed an increased mortality risk for suicide. Conclusion: Deliberate self-harm patients presenting to the ED who refuse treatment represent a specific target group for setting up dedicated prevention schemes.


Author(s):  
Marília de Oliveira Crispim ◽  
Cândida Maria Rodrigues dos Santos ◽  
Iracema da Silva Frazão ◽  
Cecília Maria Farias de Queiroz Frazão ◽  
Rossana Carla Rameh de Albuquerque ◽  
...  

Objective: to identify the prevalence of suicidal behavior in young university students. Method: a systematic review with meta-analysis of cross-sectional studies based on the Joanna Briggs Institute proposal, and carried out in the PubMed, Web of Science, Scopus, PsycINFO and LILACS databases and in the Brazilian Digital Library of Theses and Dissertations, with no language or year restrictions. A total of 2,942 publications were identified. Selection, data extraction and methodological evaluation of the studies were performed by two independent researchers. The meta-analysis was performed considering the random effects model. Results: eleven articles were included in this review. The prevalence variation for suicidal ideation was from 9.7% to 58.3% and, for attempted suicide, it was from 0.7% to 14.7%. The meta-analysis showed a 27.1% prevalence for suicidal ideation in life, 14.1% for ideation in the last year, and 3.1% for attempted suicide in life. Conclusion: the high prevalence of suicidal behavior, even with the considerable heterogeneity of the studies, raises the need to implement interventions aimed at preventing suicide and promoting mental health, especially in the academic environment.


1998 ◽  
Vol 26 (2) ◽  
pp. 115-131 ◽  
Author(s):  
Jeffrey E. Hecker ◽  
Christine M. Fink ◽  
Nancy D. Vogeltanz ◽  
Geoffrey L. Thorpe ◽  
Sandra T. Sigmon

The relative efficacy of cognitive restructuring and interoceptive exposure procedures for the treatment of panic disorder, as well as the differential effects of the order of these interventions, was studied. Eighteen clients with panic disorder were seen for four sessions of exposure therapy and four sessions of cognitive therapy in a crossover design study. Half of the participants received exposure therapy followed by cognitive therapy and for half the order was reversed. There was a 1-month follow-up period between the two interventions and after the second intervention. Questionnaire measures and independent clinician ratings were used to assess outcome. Participants expected greater benefit from cognitive therapy, but tended to improve to a similar degree with either intervention. The order in which treatments were presented did not influence outcome. Participants tended to improve with the first intervention and maintain improvement across the follow-up periods and subsequent intervention. Several methodological limitations qualify the conclusions that can be drawn from this study. These limitations, as well as some conceptual and methodological challenges of conducting this type of research, are discussed.


2018 ◽  
Vol 9 (4) ◽  
Author(s):  
Micheli Leal Ferreira ◽  
Mara Ambrosina De Oliveira Vargas ◽  
Jeferson Rodrigues ◽  
Daiane Trentin ◽  
Laura Cavalcanti de Farias Brehmer ◽  
...  

Objetivo: Conhecer as evidências relativas ao comportamento suicida na atenção primária à saúde, em produções científicas nacionais e internacionais. Metodologia: Revisão integrativa da literatura de janeiro de 2012 a abril de 2017. Utilizaram-se os termos: “Suicídio”, “Tentativa de suicídio”, “Ideação suicida” e “Atenção Primária à Saúde” resultando em 35 artigos. Resultados: Predominam estudos com enfoque na avaliação da prevalência de comportamento suicida; na descrição/avaliação da eficácia na prevenção/detecção de pessoas com comportamento suicida; e na identificação do perfil/fatores de risco ou proteção de pessoas com comportamento suicida que utilizaram a atenção primária. Evidenciou a necessidade em estudos com destaque à atenção primária à saúde, principal porta de entrada da pessoa em sofrimento. Conclusão: Uma lacuna importante a ser preenchida é a carência de estudos que enfoquem a identificação/desenvolvimento de estratégias de sensibilização/ capacitação dos profissionais da atenção primária para intervenção/prevenção ao comportamento suicida.DESCRITORES: Suicídio; Tentativa de suicídio; Ideação suicida; Atenção Primária à Saúde.SUICIDAL BEHAVIOR AND PRIMARY HEALTH CARE: AN INTEGRATIVE REVIEWObjective: To know the evidence regarding suicidal behavior in primary health care in national and international scientific productions. Methodology: Integrative review of the literature from January 2012 to April 2017. The terms “Suicide”, “Attempted suicide”, “Suicidal ideation” and “Primary health care” were used, resulting in 35 articles. Results: Predominant studies focus on the evaluation of the prevalence of suicidal behavior; in the description / evaluation of effectiveness in the prevention / detection of people with suicidal behavior; and the identification of the profile / risk factors or protection of people with suicidal behavior who used primary care. It evidenced the need in studies with emphasis on primary health care, the main entry point of the suffering person. Conclusion: An important gap to be filled is the lack of studies that focus on the identification / development of awareness strategies / training of primary care professionals for intervention / prevention of suicidal behavior.Descriptors: Suicide; Attempted suicide; Suicidal ideation; Primary Health Care.COMPORTAMIENTO SUICIDIO Y ATENCIÓN PRIMARIA A LA SALUD: UNA REVISIÓN INTEGRATIVAObjetivo: Conocer las evidencias relativas al comportamiento suicida en la atención primaria a la salud, en producciones científicas nacionales e internacionales. Metodología: Revisión integrativa de la literatura de enero de 2012 a abril de 2017. Se utilizaron los términos: “Suicidio”, “Tentativa de suicidio”, “Ideación suicida” y “Atención Primaria a la Salud” resultando en 35 artículos. Resultados: Predominan estudios con enfoque en la evaluación de la prevalencia de comportamiento suicida; en la descripción / evaluación de la eficacia en la prevención / detección de personas con comportamiento suicida; y en la identificación del perfil / factores de riesgo o protección de personas con comportamiento suicida que utilizaron la atención primaria. Evidenció la necesidad en estudios con destaque a la atención primaria a la salud, principal puerta de entrada de la persona en sufrimiento. Conclusión: Una laguna importante a ser llenada es la carencia de estudios que enfoquen la identificación / desarrollo de estrategias de sensibilización / capacitación de los profesionales de la atención primaria para intervención / prevención al comportamiento suicida.Descriptores: Suicidio; Tentativa de Suicidio; Idea Suicida; Atención Primaria a la Salud.


Crisis ◽  
2007 ◽  
Vol 28 (1) ◽  
pp. 4-10 ◽  
Author(s):  
E.M. Cosgrave ◽  
J. Robinson ◽  
K.A. Godfrey ◽  
H.P. Yuen ◽  
E.J. Killackey ◽  
...  

Abstract. Suicidal behavior is associated with negative outcomes, including completed suicide. This study examined the prevalence of suicidal behavior in a sample of referrals to a youth psychiatric service and investigated the stability of suicidality over 2 years. Of the 140 people (mean age 17.8) who were referred to a youth psychiatric service, 82 who were accepted for treatment (RA group) and 58 who were not accepted (RNA group) were assessed; 57% reported considering suicide and 39% reported attempting suicide in the 12 months prior to referral. Participants who reported suicidal ideation were significantly more likely than nonsuicidal participants to have multiple Axis I diagnoses and lower levels of functioning. At the 2-year follow-up there was a significant reduction in suicidality in the RA group, but not in the RNA group. In conclusion, suicidality is prevalent among young people referred to psychiatric services. Even brief contact with services results in a reduction in suicidality over 2 years.


2002 ◽  
Vol 30 (4) ◽  
pp. 423-430 ◽  
Author(s):  
Karin Elsesser ◽  
Angelika Mosch ◽  
Gudrun Sartory

This study compared complaints management training and cognitive therapy (reattribution) in treating panic disorder. Both treatment groups received three sessions with initial psychoeducation. Thirty patients with panic disorder took part in the study. Assessments were carried out before and after treatment and again at a 4-week follow-up. Both groups showed similarly significant improvements and maintenance of the clinical change over the follow-up period. It is concluded that the initial psychoeducation, which conveyed to patients the cognitive-behavioural model of panic disorder, contributed to the treatment outcome.


Author(s):  
Eduardo Valenciano-Mendoza ◽  
Fernando Fernández-Aranda ◽  
Roser Granero ◽  
Mónica Gómez-Peña ◽  
Laura Moragas ◽  
...  

Addictive disorders are characterized by severe consequences, including suicidal events, but most studies investigating the association between addiction and suicidal risk have focused on substance use disorders and gambling disorder at the expense of the rest of behavioral addictions. This study examined the prevalence and the associated clinical correlates of suicidal ideation and suicide attempts in a sample of patients with a diagnosis of behavioral addiction. The total sample consisted of 4404 individuals: 4103 of these patients with gambling disorder, 99 with gaming disorder, 44 with sex addiction, and 158 with buying–shopping disorder. All of them were assessed consecutively at a specialized hospital unit for the treatment of behavioral addictions. Participants attended two clinical interviews and completed self-reported questionnaires to explore clinical features of behavioral addictions, personality traits, psychopathological symptomatology, suicidal behavior, and sociodemographic variables. The highest prevalence of suicidal ideation was found in patients with gambling disorder (22.9%), followed by buying–shopping disorder (18.4%), sex addiction (18.2%), and gaming disorder (6.1%). The highest prevalence of suicide attempts was registered for sex addiction (9.1%), followed by buying–shopping disorder (7.6%), gambling disorder (6.7%), and gaming disorder (3.0%). Female gender and unemployment constituted two relevant sociodemographic factors associated with suicidal risk in gambling disorder, gaming disorder, and buying–shopping disorder. Lack of family support appeared as a relevant risk factor, except for gaming disorder. These results pointed out that suicide is a prevalent behavior in behavioral addictions, and clinicians and researchers need to pay particular attention to the specificities of each behavioral addiction when assessing suicidal risk.


2020 ◽  
Vol 27 ◽  
pp. e45607
Author(s):  
Roberto Nascimento de Albuquerque ◽  
Moema Da Silva Borges ◽  
Pedro Sadi Monteiro

Objetivo: identificar o perfil do comportamento suicida entre estudantes de enfermagem de instituição privada de ensino superior do Distrito Federal. Métodos: estudo descritivo, mediante análise estatística, realizado com 1567 estudantes de enfermagem, em 2017. Foram utilizados um questionário sociodemográfico e acadêmico, a Escala de Ideação Suicida de Beck e Mini-Rastreamento de Transtornos Mentais. A pesquisa foi aprovada por Comitê de Ética em Pesquisa. Resultados: a maioria era adulto jovem, do sexo feminino e estudava no período noturno. Verificou-se que 181 (11,55%) estudantes já tinham tentado suicídio e os maiores índices foram apresentados no primeiro, terceiro e quarto semestres do curso. Destes, 36,5% apresentaram pensamentos depressivos, 33,7% sinais de depressão e desesperança e 56,4% permaneciam com ideação suicida. Conclusão: as tentativas de suicídio têm sua maior magnitude entre estudantes mais jovens, dos primeiros dois anos do curso, os quais revelaram índices expressivos para depressão, desesperança e ideação suicida.ABSTRACT Objective: to identify the profile of suicidal behavior among nursing students at a private higher education institution in the Federal District, Brazil. Methods: descriptive study, through statistical analysis, conducted with 1567 nursing students, in 2017. It was used a sociodemographic and academic questionnaire, Beck's Suicidal Ideation Scale and Mini-Screening of Mental Disorders. The research was approved by the Research Ethics Committee. Results: most respondents were young adults, female and night students One hundred and eithy-one students (11,55%) had already attempted suicide and the highest rates were presented in de first, third and fourth semesters of the course. Among them, 36,5% had depressive thoughts, 33,7% showed signs of depression and hopelessness and 56,4% remained with suicidal ideation. Conclusion: suicide attempts have their greatest magnitude among younger students, from the first two years of the course, which revealed expressive rates for depression, hopelessness and suicidal ideation.RESUMEN Objetivo: identificar el perfil de comportamiento suicida entre estudiantes de enfermería en una institución privada de educación superior en Brasil. Métodos: estudio descriptivo, mediante análisis estadístico, realizado con 1567 estudiantes de enfermería, en 2017. Se utilizó cuestionario sociodemográfico y académico, Escala de ideación suicida de Beck y mini-detección de trastornos mentales. La investigación fue aprobada por el Comité de Ética de Investigación. Resultados: la mayoría eran adultos jóvenes, mujeres y estudiavan por la noche; 181 (11,55%) estudiantes ya habían intentado suicidarse y las tasas más altas se presentaron en el primer, tercer y cuarto semestre del curso. De estos, 36,5% tenía pensamientos depresivos, 33,7% mostró signos de depresión y desesperanza y 56,4% permaneció con ideación suicida. Conclusión: los intentos de suicidio tienen su mayor magnitud entre los estudiantes más jóvenes, desde los primeros años del curso, que revelaron tasas expresivas de depresión, desesperanza e ideación suicida.


Crisis ◽  
2020 ◽  
Vol 41 (5) ◽  
pp. 337-343 ◽  
Author(s):  
Mariann Ring ◽  
Anja Gysin-Maillart

Abstract. Background: The therapeutic alliance may be a moderating factor of outcome in the Attempted Suicide Short Intervention Program (ASSIP). Aims: This study investigates the two components of the therapeutic alliance, patients' satisfaction with the therapeutic relationship and therapeutic outcome and their associations with suicidal ideation over time. Method: A total of 120 patients (55% female; mean age = 36 years) with a history of attempted suicide were randomly allocated to either the intervention group ( N = 60) or the control group ( N = 60). Patients' satisfaction with the therapeutic relationship and outcome were measured with the two subscales of the Helping Alliance Questionnaire. The Beck Scale of Suicide Ideation was used to measure suicidal ideation in this 24-month follow-up study. Results: The ASSIP group showed that patients' satisfaction with therapeutic relationship and outcome increased significantly from the first to the third session. Higher satisfaction with therapeutic outcome correlated significantly with lower suicidal ideation at follow-up. Conversely, the control group showed no significant results. Limitations: The collaborative approach adopted in the initial clinical interview of the control group could possibly have influenced the results of both scales. Conclusion: In particular, the component satisfaction with therapeutic outcome seems crucial to the subjectively perceived satisfaction of treatment and is associated with lower suicidal ideation over time. Thus, an enhanced understanding of components of the therapeutic alliance plays an important role in the development of interventions for suicidal patients.


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