SUICIDAL IDEATION AND SUICIDE ATTEMPTS IN PANIC DISORDER AND ATTACKS
SUICIDAL IDEATION AND SUICIDE ATTEMPTS IN PANIC DISORDER AND ATTACKS
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DOI：
10.1056/nejm198911023211801
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发表时间：
1989-11-02
影响因子：
158.5
通讯作者：
OUELLETTE, R
中科院分区：
文献类型：
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作者：
WEISSMAN, MM;KLERMAN, GL;OUELLETTE, R
恐慌症，这是发现在约1.5%的人口在他们的生活中的某个时候，包括反复发作的突然，不可预测的，强烈的恐惧伴随着症状，如心悸，胸痛和昏厥。不完全符合这些诊断标准的恐慌发作的发病率要高出两到三倍。由于恐慌症状可以模仿其他医学疾病的症状，因此有这些症状的患者经常使用医疗服务。为了确定惊恐障碍和攻击中自杀意念和自杀企图的风险，我们研究了来自美国五个社区的18，011名成年人的随机样本。与其他精神疾病相比，惊恐障碍受试者有更多的自杀意念和自杀企图，自杀企图的调整优势比为2.62（95%置信区间，1.83至3.74）。当惊恐障碍组与无精神障碍的受试者相比时，优势比为17.99（95%置信区间，12.18至26.58）。20%的惊恐障碍患者和12%的惊恐发作患者曾试图自杀。这些结果不能用抑郁症、酒精或药物滥用的共存来解释。我们的结论是，惊恐障碍和攻击与自杀意念和自杀企图的风险增加。在一般医疗机构和急诊科工作的医生应该警惕这个问题。
Panic disorder, which is found in about 1.5 percent of the population at some time in their lives, includes recurrent episodes of sudden, unpredictable, intense fear accompanied by symptoms such as palpitations, chest pain and faintness. Panic attacks, which do not meet these diagnostic criteria fully, are two to three times more prevalent. Since panic symptoms can mimic those of other medical disorders, patients with these symptoms use medical services frequently. To determine the risk of suicidal ideation and suicide attempts in panic disorder and attacks, we studied a random sample of 18,011 adults drawn from five U.S. communities. Subjects who had panic disorder, as compared with other psychiatric disorders, had more suicidal ideation and suicide attempts, with an adjusted odds ratio for suicide attempts of 2.62 (95 percent confidence interval, 1.83 to 3.74). The odds ratio was 17.99 (95 percent confidence interval, 12.18 to 26.58) when the group with panic disorder was compared with subjects who had no psychiatric disorder. Twenty percent of the subjects with panic disorder and 12 percent of those with panic attacks had made suicide attempts. These results could no be explained by the coexistence of major depression or of alcohol or drug abuse. We conclude that panic disorder and attacks are associated with an increased risk of suicidal ideation and suicide attempts. Physicians working in general medical settings and emergency departments should be alert to this problem.