Anxiety symptoms among psychiatric outpatients: Prevalence and association with suicide risk

Objective: To determine the association between anxiety symptoms and suicidal ideation (SI) among psychiatric outpatients. Method: Participants (n = 2939) were individuals treated for psychiatric illness who completed a clinical diagnostic interview and a comprehensive self-report psychosocial questionnaire. Logistic regression determined an odds ratio (OR) and a 95% confidence interval (95% CI) for the association between self-reported “fear/anxiety/panic” symptoms (FAP) and SI after controlling for clinically relevant variables including diagnosis of major depressive disorder (MDD). The effects of self-reported FAP, depressive symptoms, and the combination on risk of SI were also explored. Descriptive statistics examined included the prevalence of FAP, overall and by primary diagnosis. Results: FAP rated >moderate was the strongest predictor of SI (OR = 3.00, 95% CI=2.50, 3.61), followed by MDD (OR = 2.33, 95% CI=1.97, 2.76). Male gender (OR = 0.71, 95% CI=0.60, 0.85) and continuous age (OR = 0.99, 95% CI=0.98, 0.99) were associated with slightly decreased risks of SI. Participants reporting co-existing >moderate depressive and FAP demonstrated the highest risk for SI, and this effect was stronger in those age <50 years (OR = 40.75, 95% CI=20.05, 82.86) versus >50 years (OR = 19.08, 95% CI=7.83, 50.13). FAP >moderate was common for the entire sample (61.5%) and across all diagnoses: anxiety (87.1%), MDD (71.6%), bipolar (60.8%), schizoaffective (58.9%), and schizophrenia (42.9%). Conclusions: Anxiety symptoms are very common among psychiatric outpatients. The importance of assessing for FAP in all patients, regardless of diagnosis, is highlighted by the significant association between FAP and SI.