Suicidal ideation in emergency department chest pain patients: Panic disorder a risk factor

被引:21
作者
Fleet, RP
Dupuis, G
Kaczorowski, J
Marchand, A
Beitman, BD
机构
[1] Department of Psychosomatic Medicine, Montreal Heart Institute, Montreal, Que.
[2] Department of Psychosomatic Medicine, Univ. du Quebec a Montreal, Montreal, Que.
[3] Department of Psychosomatic Medicine, University of Missouri-Columbia, Columbia, MO
[4] Department of Psychosomatic Medicine, Montreal Heart Institute, Montreal, Que. H1T 1C8
关键词
panic disorder; emergency department; suicidal behavior;
D O I
10.1016/S0735-6757(97)90121-2
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Most patients who present to the emergency department (ED) for chest pain do not have a cardiac disorder, Approximately 30% of noncardiac chest pain patients suffer from panic disorder (PD), a disabling, treatable, yet rarely detected psychiatric condition, Although still controversial, PD may be a risk factor for suicidal ideation and attempts. The prevalence of recent suicidal ideation (ie, past week) was studied in 441 consecutive ED chest pain patients who underwent a structured psychiatric interview. To examine the controversial link between panic and suicidal behavior, logistic regression analyses were conducted in which current psychiatric diagnoses (Axis I) as well as pertinent medical and demographic information were assessed as risk factors for suicidal ideation, Participants were interviewed with the Anxiety Disorders Interview Schedule-Revised to establish psychiatric diagnoses, Recent suicidal ideation (ie, past week) was assessed with question 9 of the Beck Depression Inventory, Ten percent of patients had recent suicidal ideation, Sixty percent of patients with suicidal thoughts met criteria for PD. In the patients with PD, suicidal ideation could not be explained by the presence of comorbid psychiatric or medical conditions or medication. In the total sample, only diagnoses of PD (odds ratio [OR] = 4.3; 95% confidence interval [CI], 2.09-8.82; P = .0001) and dysthymia (OR = 9.98; 95% CI, 4.00-24.8; P = .00001) were significant and independent risk factors for suicidal ideation, PD, the most common psychiatric condition in ED chest pain patients, may be an independent risk factor for suicidal ideation, further supporting the need for recognition and treatment of these patients. Copyright (C) 1997 by W.B. Saunders Company.
引用
收藏
页码:345 / 349
页数:5
相关论文
共 46 条
[2]  
Beck A.T., 1967, DEPRESSION
[3]  
BECK AT, 1991, AM J PSYCHIAT, V148, P1195
[4]   FOLLOW-UP STATUS OF PATIENTS WITH ANGIOGRAPHICALLY NORMAL CORONARY-ARTERIES AND PANIC DISORDER [J].
BEITMAN, BD ;
KUSHNER, MG ;
BASHA, I ;
LAMBERTI, J ;
MUKERJI, V ;
BARTELS, K .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1991, 265 (12) :1545-1549
[5]   PANIC DISORDER IN PATIENTS WITH CHEST PAIN AND ANGIOGRAPHICALLY NORMAL CORONARY-ARTERIES [J].
BEITMAN, BD ;
MUKERJI, V ;
LAMBERTI, JW ;
SCHMID, L ;
DEROSEAR, L ;
KUSHNER, M ;
FLAKER, G ;
BASHA, I .
AMERICAN JOURNAL OF CARDIOLOGY, 1989, 63 (18) :1399-1403
[6]   ATYPICAL OR NONANGINAL CHEST PAIN - PANIC DISORDER OR CORONARY-ARTERY DISEASE [J].
BEITMAN, BD ;
BASHA, I ;
FLAKER, G ;
DEROSEAR, L ;
MUKERJI, V ;
TROMBKA, L ;
KATON, W .
ARCHIVES OF INTERNAL MEDICINE, 1987, 147 (09) :1548-1552
[7]   PANIC DISORDER AND SUICIDALITY - PREVALENCE AND RISK-FACTORS [J].
BORDEN, JW .
JOURNAL OF ANXIETY DISORDERS, 1994, 8 (03) :217-225
[8]   COMORBIDITY AMONG ANXIETY DISORDERS - IMPLICATIONS FOR TREATMENT AND DSM-IV [J].
BROWN, TA ;
BARLOW, DH .
JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY, 1992, 60 (06) :835-844
[9]   PANIC DISORDER AND CHEST PAIN - A STUDY OF CARDIAC STRESS SCINTIGRAPHY PATIENTS [J].
CARTER, C ;
MADDOCK, R ;
ZOGLIO, M ;
LUTRIN, C ;
JELLA, S ;
AMSTERDAM, E .
AMERICAN JOURNAL OF CARDIOLOGY, 1994, 74 (03) :296-298
[10]   PANIC DISORDER AND CHEST PAIN IN THE CORONARY-CARE UNIT [J].
CARTER, C ;
MADDOCK, R ;
AMSTERDAM, E ;
MCCORMICK, S ;
WATERS, C ;
BILLETT, J .
PSYCHOSOMATICS, 1992, 33 (03) :302-309