Henriksson M M, Isometsä E T, Kuoppasalmi K I, Heikkinen M E, Marttunen M J, Lönnqvist J K
Department of Mental Health, National Public Health Institute, Helsinki, Finland.
J Clin Psychiatry. 1996 Jul;57(7):275-81.
Patients with panic disorder are reportedly at increased risk of suicidal behavior, but in psychological autopsy studies of completed suicides, a current diagnosis of panic disorder has been rare or absent. The comorbidity and other clinical characteristics of panic disorder among suicides are not known.
On the basis of data from a psychological autopsy study of all suicides (N = 1397) in Finland occurring during 1 year, all victims with current DSM-III-R panic disorder were retrospectively identified and examined in terms of comorbidity, suicide methods, history of suicide attempts, treatment setting, and duration of panic disorder.
Seventeen victims with current panic disorder, 1.2% of all suicides, were identified. The prevalence of panic disorder was higher among female (2.8%, 9 of 320) than male suicides (0.7%, 8 of 1077; p = .007). All victims with panic disorder suffered concurrent Axis I disorders, and 8 (47%) Axis II disorders. Major depression was diagnosed in 10 (59%), and substance dependence or abuse in 8 (47%) of the cases. The mean duration of panic disorder before suicide was 8 years. In most cases, the onset of panic disorder preceded comorbid Axis I disorders and previous suicide attempts. Most victims with panic disorder had a history of psychiatric treatment.
Current panic disorder, and noncomorbid panic disorder in particular, seem to be rare among completed suicides. Suicide in persons with panic disorder is associated with superimposed major depression and substance abuse, and with personality disorders. For recognizing panic disorder patients at risk of suicide, the assessment and monitoring of the overall psychopathology are essential.
据报道，惊恐障碍患者的自杀行为风险增加，但在对自杀身亡者进行的心理解剖研究中，目前很少诊断出或根本没有诊断出惊恐障碍。自杀者中惊恐障碍的共病情况及其他临床特征尚不清楚。
基于对芬兰一年内所有自杀事件（N = 1397）进行的心理解剖研究数据，回顾性识别出所有目前患有DSM-III-R惊恐障碍的受害者，并从共病情况、自杀方式、自杀未遂史、治疗背景及惊恐障碍病程等方面进行检查。
识别出17名目前患有惊恐障碍的受害者，占所有自杀者的1.2%。女性自杀者中惊恐障碍的患病率（2.8%，320例中有9例）高于男性自杀者（0.7%，1077例中有8例；p = 0.007）。所有患有惊恐障碍的受害者同时患有轴I障碍，8例（47%）患有轴II障碍。10例（59%）被诊断为重度抑郁症，8例（47%）存在物质依赖或滥用。自杀前惊恐障碍的平均病程为8年。在大多数情况下，惊恐障碍的发作先于共病的轴I障碍和既往自杀未遂。大多数患有惊恐障碍的受害者有精神科治疗史。
目前的惊恐障碍，尤其是无共病的惊恐障碍，在自杀身亡者中似乎很少见。惊恐障碍患者的自杀与叠加的重度抑郁症、物质滥用及人格障碍有关。为识别有自杀风险的惊恐障碍患者，对整体精神病理学的评估和监测至关重要。
