Am J Psychiatry 1992; 149:680-685
Copyright © 1992 by American Psychiatric Association
Suicidal ideation and suicide attempts among patients with panic disorder: a survey of two outpatient clinics
S Friedman, JC Jones, L Chernen and DH Barlow
Department of Psychiatry, State University of New York, Brooklyn 11203.
OBJECTIVE: Recent epidemiologic studies found that 20% of subjects with the
diagnosis of panic disorder had attempted suicide. This study sought to
determine the prevalence of suicidal ideation and suicide attempts among
patients with panic disorder and whether the presence of comorbid
borderline personality disorder influenced the prevalence of suicidal
thoughts and behavior. METHOD: At two outpatient clinics, experienced
clinicians conducted retrospective reviews of data from the intake
interviews and charts of 59 patients with panic disorder and comorbid
borderline personality disorder and 234 patients with panic disorder with
or without axis II disorders other than borderline personality disorder.
RESULTS: Suicide attempts were reported by 2% of the patients with panic
disorder, compared to 25% of the patients with both panic disorder and
borderline personality disorder. In addition, 2% of the patients with panic
disorder, compared to 27% of the patients with panic disorder and
borderline personality disorder, reported suicidal ideation that was judged
to be of clinical significance. CONCLUSIONS: The rate of suicidal ideation
and suicide attempts for psychiatric outpatients with panic disorder was
discrepant with the findings of the earlier studies. The increased suicide
risk in this group of patients was associated with borderline personality
disorder, increased substance abuse, and affective instability. While 61%
of the panic disorder patients and 78% of the patients with both panic
disorder and borderline personality disorder reported thinking about death,
this must be distinguished from actual suicidal ideation and clinical risk
of suicide.
