Risk factors for suicidality in patients with panic disorder: A systematic review and meta-analysis

•Patients with panic disorder are more likely to attempt suicide.•This is the first meta-analysis of its kind.•Scales of symptoms were related to suicidal behavior in panic disorder.•Factors related to the duration of the panic disorder were related to suicidality.•Alcohol dependence was associated...

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Bibliographic Details
Published in:Neuroscience and biobehavioral reviews 2019-10, Vol.105, p.34-38
Main Authors: Tietbohl-Santos, Bárbara, Chiamenti, Paula, Librenza-Garcia, Diego, Cassidy, Ryan, Zimerman, Aline, Manfro, Gisele Gus, Kapczinski, Flávio, Passos, Ives Cavalcante
Format: Article
Language:English
Subjects:
Meta-analysis
Panic disorder
Risk factors
Suicide
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Summary:•Patients with panic disorder are more likely to attempt suicide.•This is the first meta-analysis of its kind.•Scales of symptoms were related to suicidal behavior in panic disorder.•Factors related to the duration of the panic disorder were related to suicidality.•Alcohol dependence was associated to suicide attempts in panic disorder. Subjects with panic disorder are nearly 4 times as likely to attempt suicide as compared to subjects without this condition. We searched the literature from Jan 1, 1960 to May, 4, 2019. Articles that reported a dichotomous sample of patients with panic disorder with and without suicidal behavior were included. Twelve studies with 1958 participants were included. Comorbid depression (k = 3, ES = 4.47 [2.63; 7.60]), depressive symptoms (k = 2, ES = 1.98 [1.26; 3.11]), older age (k = 3, ES = 1.66 [1.32; 2.10]), younger age of panic disorder onset (k = 2, ES = 0.65 [0.45; 0.94]), and history of alcohol dependence (k = 2, ES = 8.70 [1.20; 63.04]) were associated with suicide attempt in panic disorder. Depressive symptoms (k = 2, ES = 2.29 (1.60; 3.37]), anxiety symptoms (k = 2, ES = 1.90 [1.33; 2.69]), longer illness duration (k = 2, ES = 3.31 [1.90; 5.74]), comorbid depressive disorder (k = 4, ES = 3.88 [2.03; 7.41]), agoraphobia (k = 2, ES = 4.60 [1.47; 14.42]) and younger age of onset (k = 2, ES = 0.60 [0.38; 0.96]) were associated with suicidal ideation in panic disorder. Our findings provide a framework for the development of suicide prevention strategies in this population.
ISSN:0149-7634
1873-7528
DOI:10.1016/j.neubiorev.2019.07.022