Johnson J, Weissman M M, Klerman G L
New York State Psychiatric Institute, NY 10032.
Arch Gen Psychiatry. 1990 Sep;47(9):805-8. doi: 10.1001/archpsyc.1990.01810210013002.
In a previous report, we demonstrated a strong association between panic disorder and suicide attempts based on data from the Epidemiologic Catchment Area study (a probability sample of more than 18,000 adults living in five US communities). In these analyses, although we controlled statistically for comorbidity of panic disorder with other psychiatric disorders, we did not directly estimate the risk of suicide attempts in persons with uncomplicated panic disorder (ie, without any other Axis I disorders) compared with those with comorbid conditions. Persons with uncomplicated panic disorder represent fewer than a third of persons with panic disorder. However, the lifetime rates of suicide attempts in persons with uncomplicated panic disorder (7%) were consistently higher than for persons with no psychiatric disorder (1%). Similar findings on the rate of suicide attempts in persons with uncomplicated major depression (7.9%) emerged. We conclude that suicide attempts are associated with panic disorder in its uncomplicated or its comorbid form and that the risks are comparable with those of major depression, comorbid and uncomplicated. These epidemiologic findings are discussed within a clinical perspective to explain why these associations may not appear obvious in clinical practice.
在之前的一份报告中，我们基于流行病学集水区研究的数据（来自美国五个社区的18000多名成年人的概率样本）证明了惊恐障碍与自杀未遂之间存在密切关联。在这些分析中，尽管我们对惊恐障碍与其他精神障碍的共病情况进行了统计学控制，但我们没有直接估计单纯惊恐障碍患者（即没有任何其他轴I障碍）与合并其他疾病的患者相比自杀未遂的风险。单纯惊恐障碍患者占惊恐障碍患者的比例不到三分之一。然而，单纯惊恐障碍患者的终身自杀未遂率（7%）一直高于无精神障碍患者（1%）。在单纯重度抑郁症患者（7.9%）中也出现了类似的自杀未遂率结果。我们得出结论，自杀未遂与单纯或合并形式的惊恐障碍有关，且这些风险与重度抑郁症（合并和单纯形式）的风险相当。我们从临床角度讨论了这些流行病学发现，以解释为什么这些关联在临床实践中可能不明显。
