Panic attacks increase suicide attempts.

Panic attacks increase suicide attempts

Some psychiatric conditions, such as severe depression and schizophrenia, are known to increase a person's risk of suicide. But panic attacks and panic disorder, defined as frequently recurring panic attacks, are also linked to a strong and largely unappreciated risk of contemplating and attempting suicide, according to a new study.

Surprisingly, people with panic disorder have a higher rate of suicide attempts than do severely depressed individuals, report psychologist Myrna M. Weissman of Columbia University in New York City and her colleagues in the Nov. 2 NEW ENGLAND JOURNAL OF MEDICINE.

This finding is "quite remarkable" and marks panic disorder as a major new risk factor for suicide, writes psychiatrist Peter Reich of the Massachusetts Institute of Technology in Cambridge in an editorial in the same journal. Reich also notes that general practice physicians, who most commonly encounter panic disorder patients, can help prevent suicides by recognizing and treating symptoms of the disorder.

Panic disorder afflicts an estimated 1.5 percent of the U.S. population at some time in their lives. It involves repeated episodes of sudden, unpredictable, intense fear accompanied by symptoms such as heart palpitations, chest pain, faintness and the sense that one is about to die or go crazy. Less frequent panic attackes affect 3 to 4 percent of the population.

Weissman and her co-workers studied a random national sample of 18,011 adults taking part in a larger epidemiologic study of psychiatric disorders. Trained interviewers questioned each subject at home about psychiatric symptoms.

The 254 subjects with panic disorder and the 667 with panic attacks reported thinking about death, feeling as though they wanted to die, having thoughts of committing suicide or attempting suicide significantly more than did subjects with any other psychiatric disorder or with no disorder. One in five people with panic disorder had attempted suicide, compared with about one in eight with panic attacks, one in 16 with another psychiatric disorder and one in 100 with no disorder.

When the researchers statistically controlled for panic subjects who had another psychiatric disorder, such as severe depression or alcohol abuse, such as still found substantially more suicidal thoughts and suicide attempts among the panic group. Nevertheless, the risk of suicide attempts proved greatest for panic disorder subjects who also abused alcohol or illicit drugs. People with less frequent panic attacks were more likely to report suicide attempts if they also were alcohol abusers or severely depressed.

The researchers have no data on the rate of completed suicides among panic subjects. However, Reich notes that about one in three people who kill themselves have made previous attempts. Furthermore, a recent study in which researchers followed hospitalized pyschiatric patients with a primary diagnosis of panic disorder for 30 to 50 years revealed a significantly higher mortality rate -- primarily due to suicide or heart disease -- among these individuals than in a group of patients hospitalized for severe depression.

Subjects in the national sample with panic disorder were more likely than those with other psychiatric disorders to seek help for their emotional problems from general physicians or psychiatrists. Panic subjects were also more likely to use a hospital emergency ward, Weissman and her colleagues note. Because panic symptoms are often similar to those of medical illness, accurate diagnosis is imperative, the researchers assert. During and behavioral treatments often ease panic symptoms, they say, although there is no direct evidence that these efforts reduce suicide attempts.