Fear of Dying in Panic Attacks Predicts Suicide Attempt in Comorbid Depressive Illness: Prospective Evidence From the National Epidemiological Survey on Alcohol and Related Conditions

Yaseen, Zimri S.; Chartrand, Hayley; Mojtabai, M.P.H. Ramin; Bolton, James M.; Galynker, Igor

doi:10.1002/da.22039

Cited by 24 publications

(23 citation statements)

References 70 publications

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“…Furthermore, other studies 10,[15][16][17] report an acute, high-intensity, negative affect state that seems to serve as a trigger for SA. In agreement with this hypothesis, other reports have linked increased risk for suicide with affectively intense panic attacks, [18][19][20] and our recent national database studies 21,22 suggest that panic attacks may serve as a mediator for transition from SI to SA in depressed patients.…”

Section: Patient Acute Pre-suicidal State: Suicide Trigger Statesupporting

confidence: 84%

“…Further, we identified a six-item subscale, the STS short form (STS-SF), that we found to predict SA particularly well and efficiently, above and beyond important factors such as SA at time of admission and comorbid substance abuse (adjusted odds ratio = 8). 21 The six STS-3 items that predict imminent suicide attempts are listed in Table 1. The first two items (Did you feel trapped?…”

Section: Patient Acute Pre-suicidal State: Suicide Trigger Statementioning

confidence: 99%

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Assessing Risk for Imminent Suicide

Galynker¹,

Yaseen²,

Briggs³

2014

Psychiatric Annals

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Most suicide victims see a health professional shortly before their death; yet, at present, clinicians have no tools for identifying those at acute risk. Clinical instruments valuable in predicting suicide over a 10-year period were not effective in predicting completed suicides within a period of 6 months. In fact, the difference between chronic and imminent suicide risk has only recently been articulated in the literature. A promising approach is to assess suicide risk along multiple dimensions. In this article, we review an evaluation model that consists of four domains: 1) long-term suicide risk, 2) implicit acceptance of suicide as a solution to problems, 3) acuity of the suicidal state, and 4) clinicians' emotional response (ie, countertransference) to the acutely suicidal patient. The first domain has already been integrated into clinical practice. The review focuses on the next three dimensions and suggests ways to utilize them in clinical practice.

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Section: Patient Acute Pre-suicidal State: Suicide Trigger Statesupporting

confidence: 84%

Section: Patient Acute Pre-suicidal State: Suicide Trigger Statementioning

confidence: 99%

Assessing Risk for Imminent Suicide

Galynker¹,

Yaseen²,

Briggs³

2014

Psychiatric Annals

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“…They found that, in a sample of patients with PD, the suicide risk was predicted by high levels of: (1) overall anxiety symptoms, (2) anticipatory anxiety, (3) avoidance of bodily sensations, (4) attentional vigilance toward bodily perturbations, and (5) phrenophobia. In another study, Yaseen et al [12] revealed a positive association between suicide risk and fear of dying among patients with panic attacks. These discrepancies may be explained by methodological differences, such as the type and severity of comorbidity and the extent to which it was assessed and described.…”

Section: Introductionmentioning

confidence: 99%

Clinical Symptoms Associated with Suicidality in Patients with Panic Disorder

Lim

Shin

et al. 2015

Psychopathology

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Background: Patients with panic disorder have higher rates of suicide than the general population. Among panic disorder subjects, early onset, female gender, alcohol abuse, and mood disorder increase the risk of suicidality. However, less is known about the unique relationships between discrete DSM-IV panic symptoms and higher suicidality. Therefore, in the current study we examined the panic symptom profile that is associated with higher suicidality in a sample of outpatients with panic disorder. Methods: This cross-sectional study included 427 patients diagnosed with current panic disorder on the basis of the DSM-IV-TR. In order to assess the contribution of the clinical variables, a univariate logistic regression was carried out examining the relationships between the demographic variables, suicidality from the suicide module of the Korean version of the MINI International Neuropsychiatric Interview Plus, and DSM-IV panic symptoms. Additionally, a multivariate logistic regression was performed to identify specific panic symptoms that were significant risk factors for suicidality among patients with current panic disorder. Results: We found that 74 (17.33%) panic disorder patients experienced high suicidality. Univariate analyses showed that high suicidality was significantly associated with a younger age (OR = 13.66; 95% CI 2.68-69.70), comorbid depressive disorders (OR = 4.57; 95% CI 2.57-8.11), and the following panic symptoms: palpitations (OR = 2.20; 95% CI 0.90-5.35), trembling (OR = 0.61; 95% CI 0.362-1.18), nausea or abdominal distress (OR = 1.77; 95% CI 0.96-3.27), fear of losing control or going crazy (OR = 2.18; 95% CI 1.12-4.23), and paresthesia (OR = 1.57; 95% CI 0.83-2.98). Multivariate logistic regression analyses demonstrated that specific panic symptoms, such as palpitations (adjusted OR = 2.69; 95% CI 1.08-6.73) and fear of losing control or going crazy (adjusted OR = 2.28; 95% CI 1.21-4.31), were related to suicidality after controlling for confounding factors. Conclusion: Some panic symptoms (e.g. palpitations and fear of losing control or going crazy) are associated with a risk of suicidality among patients with panic disorder. A priori identification of high-risk suicidal subjects could lead to effective treatment strategies for panic disorder.

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“…We also predicted that PD patients with FOD would exhibit higher-risk psychiatric morbidity, compared to PD patients without FOD, such as a greater number of comorbid Axis I disorders, hospitalizations, more severe suicidal ideation, a greater number of lifetime suicide attempts, and increased impairment in social and occupational functioning. Although it is counterintuitive to predict that those whom experience FOD would be at greater risk for suicide, there is indirect evidence linking fearful cognitions and FOD with suicidality (Goodwin & Hamilton, 2002;Yaseen et al, 2013). Moreover, it is plausible for an individual to fear dying from a heart attack during a panic attack while concomitantly wishing for death more generally, or less unexpectedly, as a function of a depressive disorder.…”

Section: Introductionmentioning

confidence: 99%

Does ‘fear of dying’ indicate a more severe presentation of panic disorder?

Gazarian

Multach

Ellison

et al. 2016

Journal of Anxiety Disorders

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reporting FOD (n=153) were compared to patients denying FOD (n=178) on variables indicating PD severity (e.g., number of symptoms) and psychiatric impairment (e.g., hospitalizations). PD patients with FOD reported a greater number of panic symptoms, agoraphobia diagnoses, and were more likely to be seeking treatment primarily for PD. We found no clinical impairment or comorbidity differences between groups. Results suggest that panic attacks with FOD are related to a more acute presentation of PD. Such results substantiate past research connecting cognitive distress and PD severity and further suggest that FOD may be particularly relevant to this relationship.

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Fear of Dying in Panic Attacks Predicts Suicide Attempt in Comorbid Depressive Illness: Prospective Evidence From the National Epidemiological Survey on Alcohol and Related Conditions

Abstract: PAs characterized by prominent morbid catastrophic cognitions may mediate the transition to SIs and SAs in subjects with depressive episodes. Presence of these symptoms in clinical settings may serve as a warning sign for future suicidality.

Cited by 24 publications

References 70 publications

Assessing Risk for Imminent Suicide

Assessing Risk for Imminent Suicide

Clinical Symptoms Associated with Suicidality in Patients with Panic Disorder

Does ‘fear of dying’ indicate a more severe presentation of panic disorder?

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