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Panic disorder and suicide
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DOI：10.1017/S0033291724003441.png)
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Abstract
En 中文
Background Panic disorder (PD) may increase the likelihood of suicidal ideation and behaviors because of psychiatric comorbidities such as major depressive disorder (MDD). However, research has yet to demonstrate a direct relationship between PD and suicide mortality.Method Using data from Taiwan's National Health Insurance Research Database, we identified 171,737 individuals with PD and 686,948 age- and sex-matched individuals without PD during 2003-2017. We assessed the risk of suicide within the same period. Psychiatric comorbidities such as schizophrenia, bipolar disorder, MDD, obsessive-compulsive disorder (OCD), autism, alcohol use disorder (AUD), and substance use disorder (SUD) were also evaluated. Time-dependent Cox regression models were used to compare the risk of suicide in different groups after adjustment for demographic data and psychiatric comorbidities.Results Our Cox regression model revealed that PD was an independent risk factor for suicide (hazard ratio [HR] = 1.85, 95% confidence interval [CI] = 1.59-2.14), regardless of psychiatric comorbidities. Among all comorbidities, MDD with PD was associated with the highest risk of suicide (HR = 6.08, 95% CI = 5.48-6.74), followed by autism (HR = 4.52, 95% CI = 1.66-12.29), schizophrenia (HR = 3.34, 95% CI = 2.7-4.13), bipolar disorder (HR = 3.20, 95% CI = 2.71-3.79), AUD (HR = 2.99, 95% CI = 2.41-3.72), SUD (HR = 2.82, 95% CI = 2.28-3.47), and OCD (HR = 2.10, 95% CI = 1.64-2.67).Discussion PD is an independent risk factor for suicide. Psychiatric comorbidities (i.e. schizophrenia, bipolar disorder, MDD, OCD, AUD, SUD, and autism) with PD increase the risk of suicide.
Keywords:
major depressive disorder
panic disorder
psychiatric comorbidity
suicide
Taiwan
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