Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-17T07:23:48.913Z Has data issue: false hasContentIssue false

Anxiety disorders, comorbidity, and suicide attempts in adolescence: a preliminary investigation

Published online by Cambridge University Press:  16 April 2020

C Pawlak
Affiliation:
Adolescent Psychiatry Unit, Service Médico-PédagogiqueGeneva
T Pascual-Sanchez
Affiliation:
Department of Psychiatry, University Hospitals Geneva, Geneva, Switzerland
P Raë
Affiliation:
Adolescent Psychiatry Unit, Service Médico-PédagogiqueGeneva
W Fischer
Affiliation:
Department of Psychiatry, University Hospitals Geneva, Geneva, Switzerland
F Ladame
Affiliation:
Department of Psychiatry, University Hospitals Geneva, Geneva, Switzerland
Get access

Summary

The prevalence of anxiety disorders and associated DSM-III-R diagnoses were measured in a sample of 80 female adolescents aged between 15 to 20 years consulting an outpatient psychiatric service for adolescents. The suicide attempt group (SA) included 40 patients evaluated within 24 h after attempted suicide. This is compared to 40 consecutive patients consulting the same center but without any history of suicide attempt (the no attempt group, NA).

The global prevalence of anxiety disorders was similar in both groups (SA: 65% vs. NA: 60%, NS) as was the relative importance of the different disorders in each group, generalized anxiety being the most frequent specific anxiety disorder. The most striking difference between the two groups was in the prevalence of affective disorders in 90% (SA) vs. 32.5% (NA) (P < 0.001), leading to high rates of comorbidity on axis I in the SA group. Of the 24 patients with anxiety disorders who attempted suicide, 21 (95%) fulfilled criteria for associated major depression, compared to five out of 21 (24%) patients with anxiety disorders who had not attempted suicide.

Adolescents with anxiety disorders developing major depression are at a high risk for suicide. The depression may be of short duration (less than two weeks) when compared to that of the anxiety disorder (greater than six months). To improve suicide prevention, our findings if confirmed should encourage clinicians to perform a close follow-up of adolescents with anxiety disorders for an early detection of sudden depressive breakdowns.

Type
Original Articles
Copyright
Copyright © European Psychiatric Association 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andrews, JA, Lewinsohn, PMSuicidal attempts among older adolescents: prevalence and co-occurrence with psychiatric disorders. J Am Acad Child Adolesc Psychiatry 1992 ; 31 : 655662.10.1097/00004583-199207000-00012CrossRefGoogle ScholarPubMed
Angst, J, Dobler-Mikula, AThe Zurich study. Eur Arch Psychiatr Neurol Sci 1985 ; 235 : 171178.CrossRefGoogle ScholarPubMed
Beck, AT, Steer, RA, Sanderson, WS, Skeie, TMPanic disorders and suicidal ideation and behavior: discrepant findings in psychiatric outpatients. Am J Psychiatry 1991 ; 148 : 11951199.Google ScholarPubMed
Brent, DA, Perper, JA, Moritz, G, Allman, C, Friend, A, Roth, CPsychiatric risk factors for adolescent suicide: a case-control study. J Am Acad Child Adolesc Psychiatry 1993 ; 32 : 521529.CrossRefGoogle ScholarPubMed
Davidson, JR, Hughes, DL, George, LK, Blazer, DGThe epidemiology of social phobia. Psychol M 1993 ; 23 : 709718.CrossRefGoogle ScholarPubMed
Flament, MF, Whitaker, A, Rapoport, JL, Davies, M, Zaremba Berg, C, Kalikow, KObsessive compulsive disorder in adolescence: an epidemiological study. J Am Acad Child Adolesc Psychiatry 1988 ; 27 : 764771.CrossRefGoogle Scholar
Johnson, J, Weissmann, MM, Klerman, GLPanic disorder, comorbidity and suicide attempts. Arch Gen Psychiatry 1990 ; 47 : 805808.10.1001/archpsyc.1990.01810210013002CrossRefGoogle ScholarPubMed
Kashani, JH, Orvaschel, HAnxiety disorders in mid-adolescence: a community sample. Am J Psychiatry 1988 ; 145 : 960964.Google ScholarPubMed
Kashani, JH, Orvaschel, HA community study of anxiety in children and adolescents. Am J Psychiatry 1990 ; 147 : 313318.Google ScholarPubMed
Laederach, J, Fischer, W, Bowen, P, Ladame, FCommon risk factors in adolescent suicide attempters revisited. Crisis 1999 ; 20 : 1522.CrossRefGoogle ScholarPubMed
Last, CG, Perrin, S, Hersen, M, Kazdin, AEDSM-III-R anxiety disorders in children: socio-demographic and clinical characteristics. J Am Acad Child Adolesc Psychiatry 1992 ; 6 : 10701076.CrossRefGoogle Scholar
Lewinsohn, PMTentatives de suicide à l'adolescence et facteurs de risque psychosociaux In: Ladame, FOttino, J, Pawlak, C eds. Adolescence et suicide 1995 Paris: Masson 6066.Google Scholar
Macaulay, JL, Kleinknecht, RAPanic and panic attacks in adolescents. J Anxiety Disord 1989 ; 3 : 221224.CrossRefGoogle Scholar
Macgee, R, Feehan, M, Williams, S, Partridge, F, Silva, PA, Kelly, JDSM-III disorders in a large sample of adolescents. J Am Acad Child Adolesc Psychiatry 1990 ; 29 : 611619.CrossRefGoogle Scholar
Marttunen, MJ, Aro, HM, Henriksson, M, Lönnqvist, JKMental disorders in adolescent suicide DSM-III-R axes I and II in suicides among 13 to 18 year olds in Finland. Arch Gen Psychiatry 1991 ; 48 : 834839.CrossRefGoogle Scholar
Rohde, P, Lewinsohn, PM, Seeley, JRComorbidity and unipolar depression: II Comorbidity with other mental disorders in adolescents and adults. J Abnorm Psychol 1991 ; 100 : 214222.CrossRefGoogle ScholarPubMed
Rudd, MD, Dahm, PF, Rajab, MHDiagnostic comorbidity in persons with suicidal ideation and behavior. Am J Psychiatry 1993 ; 150 : 928934.Google ScholarPubMed
Spitzer, RL, Williams, JBW, Gibbon, M, First, MBStructured clinical interview for DSM-III-R Patient edition (SCID-P, Version 1 0) 1990 Washington DC: American Psychiatric PressGoogle Scholar
Strauss, CC, Last, CG, Hersen, M, Kazdin, AEAssociation between anxiety and depression in children and adolescents with anxiety disorders. J Abnorm Child Psychol 1988 ; 16 : 5768.CrossRefGoogle ScholarPubMed
Weissmann, MM, Klerman, GL, Markowitz, JS, Ouellette, RSuicidal ideation and attempts in panic disorder. N Engl J M 1989 ; 321 : 12091214.CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.