Panic disorder and suicidal ideation in primary care.
The purpose of this study was to ascertain whether panic disorder (PD) and suicidal ideation are associated in an inner-city primary care clinic and whether this association remains significant after controlling for commonly co-occurring psychiatric disorders. We surveyed 2,043 patients attending a primary care clinic using the Primary Care Evaluation of Mental Disorders (PRIME-MD) Patient Health Questionnaire, a screening instrument that yields provisional diagnoses of selected psychiatric disorders. We estimated the prevalence of current suicidal ideation and of common psychiatric disorders including panic disorder and major depression. A provisional diagnosis of current PD was received by 127 patients (6.2%). After adjusting for potential confounders (age, gender, major depressive disorder [MDD], generalized anxiety disorder, and substance use disorders), patients with PD were about twice as likely to present with current suicidal ideation, as compared to those without PD (adjusted odds ratio [AOR] = 1.84; 95% confidence interval [CI]: 1.06-3.18; P = .03). After adjusting for PD and the above-mentioned potential confounders, patients with MDD had a sevenfold increase in the odds of suicidal ideation, as compared to those without MDD (AOR = 7.00; 95% CI: 4.42-11.08; P < .0001). Primary care patients with PD are at high risk for suicidal ideation, and patients with PD and co-occurring MDD are at especially high risk. PD patients in primary care thus should be assessed routinely for suicidal ideation and depression.
Pilowsky
Daniel J
DJ
Division of Clinical and Genetic Epidemiology, New York State Psychiatric Institute, New York, New York, USA. dp14@columbia.edu
Olfson
Mark
M
Gameroff
Marc J
MJ
Wickramaratne
Priya
P
Blanco
Carlos
C
Feder
Adriana
A
Gross
Raz
R
Neria
Yuval
Y
Weissman
Myrna M
MM
D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008913:Minority Groups; D016584:Panic Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D015995:Prevalence; D011320:Primary Health Care; D012680:Sensitivity and Specificity; D013406:Suicide, Attempted / Q000523:psychology*; D011795:Surveys and Questionnaires