Panic disorder and suicidal ideation in primary care

Daniel J. Pilowsky, Mark Olfson, Marc J. Gameroff, Priya Wickramaratne, Carlos Blanco, Adriana Feder, Raz Gross, Yuval Neria, Myrna M. Weissman

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

The purpose of this study was to ascertain whether panic disorder (PD) and suicidal ideation are associated in an inner-city primary care clinic and whether this association remains significant after controlling for commonly co-occurring psychiatric disorders. We surveyed 2,043 patients attending a primary care clinic using the Primary Care Evaluation of Mental Disorders (PMME-MD) Patient Health Questionnaire, a screening instrument that yields provisional diagnoses of selected psychiatric disorders. We estimated the prevalence of current suicidal ideation and of common psychiatric disorders including panic disorder and major depression. A provisional diagnosis of current PD was received by 127 patients (6.2%). After adjusting for potential confounders (age, gender, major depressive disorder [MDD], generalized anxiety disorder, and substance use disorders), patients with PD were about twice as likely to present with current suicidal ideation, as compared to those without PD (adjusted odds ratio [AOR] = 1.84; 95% confidence interval [CI]: 1.06-3.18; P =.03). After adjusting for PD and the above-mentioned potential confounders, patients with MDD had a sevenfold increase in the odds of suicidal ideation, as compared to those without MDD (AOR= 7.00; 95% CI: 4.42-11.08; P<.0001). Primary care patients with PD are at high risk for suicidal ideation, and patients with PD and co-occurring MDD are at especially high risk. PD patients in primary care thus should be assessed routinely for suicidal ideation and depression.

Original languageEnglish
Pages (from-to)11-16
Number of pages6
JournalDepression and Anxiety
Volume23
Issue number1
DOIs
StatePublished - 2006

Keywords

  • Depression
  • Major depressive disorder
  • Minority populations
  • Panic disorder
  • Primary care
  • Suicidal ideation
  • Suicide

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