Anxiety Symptom Severity and Long-term Risk for Suicidal Behavior in Depressive Disorders.

Area of Science:

• Psychiatry
• Clinical Psychology
• Epidemiology

Background:

• Anxiety symptom severity during major depressive episodes linearly predicts depressive episode duration over 25 years.
• The prognostic implications of anxiety comorbidity in major depressive disorder (MDD) require further investigation, particularly concerning suicidal behavior.

Purpose of the Study:

• To investigate whether anxiety comorbidity during major depressive episodes predicts increased likelihood of suicidal behavior.
• To examine anxiety symptoms and disorders as risk factors for suicide attempts and completions in a long-term cohort study.

Main Methods:

• Utilized the NIMH Collaborative Depression Study (CDS) cohort with a mean follow-up of 16.6 years.
• Assessed eight anxiety symptoms and four anxiety disorders as predictors of suicide attempts/completions.
• Conducted separate analyses for events within 2 years and beyond 2 years of follow-up.

Main Results:

• No significant association was found between baseline anxiety manifestations and overall suicide attempt risk.
• Phobic disorder diagnosis was the only anxiety diagnosis overrepresented among individuals who completed suicide.
• Psychic anxiety emerged as a risk factor for suicide attempts occurring more than 2 years post-baseline, whereas phobic anxiety showed a protective effect against suicide within this timeframe.

Conclusions:

• Anxiety comorbidity in major depressive disorder does not appear to be a significant risk factor for overall suicide attempts or completions.
• Specific anxiety presentations, like psychic anxiety, may have differential long-term associations with suicidal behavior, warranting further nuanced research.