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Suicide Attempts in Panic Disorder: Clinical Effects on Treatment Response and Link to Fear of Cognitive Dyscontrol

Published online by Cambridge University Press:  19 July 2023

H. Kim ,
H.-Y. Jung ,
M. Bang  and
S.-H. Lee
H. Kim*
Affiliation:
1Department of Psychiatry, CHA Bundang Medical Center
H.-Y. Jung
Affiliation:
2CHA University, Gyeonggi-do, Korea, Republic Of
M. Bang
Affiliation:
1Department of Psychiatry, CHA Bundang Medical Center
S.-H. Lee
Affiliation:
1Department of Psychiatry, CHA Bundang Medical Center
*
*Corresponding author.

Abstract

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Introduction

Panic disorders (PD) are associated with suicidality. The link between PD and suicide has been suggested to be depression; however, this remains controversial. Comprehensive research on the history of suicide attempts (SAs) in patients with PD is scarce.

Objectives

This study investigated the characteristics and pharmacological short- and long-term treatment responses of patients with PD, with or without SAs. Moreover, a network analysis was conducted to investigate the central symptoms and their connection to suicidality among SA-related variables with and without SAs.

Methods

We investigated the characteristics of SAs in patients with PD using PD-related scales, magnetic resonance imaging, and network approaches. A total of 1151 subjects were enrolled, including 755 patients with PD (97 with SA and 658 without SA) and 396 healthy controls. Suicide and PD-related scales were also administered.

Results

Our results revealed that the scores of all symptom severities were significantly higher in the PD+SA group than in the PD-SA group. Multiple linear regression analysis revealed that short- and long-term pharmacological treatment responses were significantly poor in the PD+SA group. Network analysis showed that fear of cognitive dyscontrol (FCD) was the strongest central symptom among strength, expected influence (1 and 2 step), randomized shortest path betweenness, and eigenvector centrality measures in PD+SA, whereas depression was the central symptom in PD-SA.Table 1.Results of multiple regression analysis to predict treatment response for patients with panic disorder.

Treatment responseat 8 weeks(n = 450)[R2 =0.19]Treatment responseat 6 month(n = 379)[R2 =0.20]Treatment responseat 1 year(n = 329)[R2 =0.22]
Βp-valueβp-valueβp-value
Gender0.100.150.140.090.080.39
Age-0.060.440.040.620.010.94
Baseline PDSS total score0.46<0.001**0.48<0.001**0.42<0.001**
Baseline BDI-II total score0.050.650.090.470.170.19
Baseline PSWQ total score-0.070.47-0.110.29-0.180.09
Baseline ASI-R total score-0.140.19-0.190.10-0.190.11
Baseline ETISR-SF total score0.070.340.040.600.110.24
A history of the suicide attempt-0.190.01*-0.200.02*-0.280.002*

Note: Model p-values <0.001.

*

p < 0.05.

**

p < 0.001.

Abbreviations: PD, panic disorder; SA, suicide attempt; PDSS, Panic Disorder Severity Scale; BDI-II, Beck Depression Inventory-II; PSWQ, Penn State Worry Questionnaire; ASI-R, Anxiety Sensitivity Inventory-Revised; ETISR-SF, The Early Trauma Inventory Self Report-Short Form.

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Conclusions

Our results suggest that SA history could be associated with high symptom severity and poor pharmacological treatment response in patients with PD and that FCD is the central symptom in the PD+SA network.

Disclosure of Interest

None Declared

Type
Abstract
Information
European Psychiatry , Volume 66 , Special Issue S1: Abstracts of the 31st European Congress of Psychiatry , March 2023 , pp. S192 - S193
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association
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