Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, DMU Psychiatrie et Addictologie, AP-HP.Centre-Université de Paris, France.
Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, MD, USA.
Gen Hosp Psychiatry. 2020 Nov-Dec;67:127-135. doi: 10.1016/j.genhosppsych.2020.09.006. Epub 2020 Oct 13.
People with panic disorder are at increased risk of suicide. Multiple factors influence their risk suggesting a need to combine them into an integrative model to develop more effective suicide prevention strategies for this population. In this report, we sought to build a comprehensive model of the 3-year risk of suicide attempt in individuals with panic disorder using a longitudinal nationally representative study, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; wave 1, 2001-2002; wave 2, 2004-2005).
We used structural equation modeling to simultaneously examine effects of six broad groups of clinical factors previously identified as potential predictors of suicide attempt in adults with panic disorder: 1) severity of panic disorder, 2) severity of comorbidity, 3) prior history of suicide attempt, 4) family history of psychiatric disorders, 5) sociodemographic characteristics and 6) treatment-seeking behavior.
The 3-year prevalence rate of suicide attempt was 4.6%. A general psychopathology factor, lower physical health-related quality of life, prior suicide attempt and a greater number of stressful life events at baseline significantly and independently predicted suicide attempt between the two waves (p < .05). R-square of the models ranged from 0.47 to 0.50.
This model may help inform future research and identify high-risk individuals among adults with panic disorder.
患有惊恐障碍的人自杀风险增加。多种因素会影响他们的风险,这表明需要将这些因素结合起来,建立一个综合模型,为这一人群制定更有效的自杀预防策略。在本报告中,我们试图使用一项全国代表性的纵向研究——国家酒精和相关条件流行病学调查(NESARC;第 1 波,2001-2002 年;第 2 波,2004-2005 年),构建一个综合模型来预测惊恐障碍患者在 3 年内自杀未遂的风险。
我们使用结构方程模型同时考察了六个广泛的临床因素组的影响,这些因素先前被确定为成人惊恐障碍患者自杀未遂的潜在预测因素:1)惊恐障碍严重程度,2)共病严重程度,3)既往自杀未遂史,4)精神疾病家族史,5)社会人口统计学特征和 6)寻求治疗的行为。
自杀未遂的 3 年患病率为 4.6%。一般心理病理学因素、较低的与身体健康相关的生活质量、既往自杀未遂史以及基线时更多的生活压力事件显著且独立地预测了两次随访之间的自杀未遂(p<.05)。模型的 R 方范围为 0.47 至 0.50。
该模型可能有助于为未来的研究提供信息,并确定惊恐障碍成年患者中的高危人群。