TY - JOUR
T1 - Prevalence, course, and determinants of suicide ideation and attempts in patients with a depressive and/or anxiety disorder
T2 - A review of NESDA findings
AU - Wiebenga, Jasper X M
AU - Dickhoff, Justine
AU - Mérelle, Saskia Y M
AU - Eikelenboom, Merijn
AU - Heering, Henriette D
AU - Gilissen, Renske
AU - van Oppen, Patricia
AU - Penninx, Brenda W J H
N1 - Copyright © 2021. Published by Elsevier B.V.
PY - 2021/3/15
Y1 - 2021/3/15
N2 - Background: Depressive and anxiety disorders are often associated with suicide ideation (SI) and attempt (SA). However, analyses of prevalence, course, and more specific risk mechanisms are needed to improve knowledge and detection of high risk individuals with depressive and anxiety disorders. Previous studies often lacked statistical power, assessment of detailed determinants and follow-up measurements. Methods: The Netherlands Study of Depression and Anxiety (NESDA), a large cohort study, overcomes some earlier limitations. Scale for Suicide Ideation and Compositive Interview Diagnostic Instrument data were analyzed to report on prevalence of SI and SA. Additionally, important sociodemographic, clinical, psychological, environmental, and neurobiological determinants and course of SI and SA identified in depressive and/or anxiety disorder respondents in 16 NESDA articles were summarized. Results: Within respondents with 12-month diagnosis (n=1,783), SI and 12-month SA prevalence ranged from 17.1-20.1% and 0.8-3.0% respectively across 5 waves during 9-year follow-up and SI was highly recurrent. Both SI and SA were especially associated with comorbid depression and anxiety, higher clinical severity, sleep dysfunctions, higher aggression and hopelessness, and childhood trauma. In the (neuro)biological domain, SI was linked with immune dysregulation and SA with abnormal brain activity during emotion processing and genetic risk. Limitations: Most articles were cross-sectional in nature, preventing causal inferences and no conclusions could be drawn about the overall magnitude of results. Conclusion: SI and SA are multifactorial phenomena and especially prevalent amongst comorbid depressive and anxiety respondents. Considering many overlapping SI and SA determinants, more neurobiological determinants and use of innovative methodological techniques are desirable.
AB - Background: Depressive and anxiety disorders are often associated with suicide ideation (SI) and attempt (SA). However, analyses of prevalence, course, and more specific risk mechanisms are needed to improve knowledge and detection of high risk individuals with depressive and anxiety disorders. Previous studies often lacked statistical power, assessment of detailed determinants and follow-up measurements. Methods: The Netherlands Study of Depression and Anxiety (NESDA), a large cohort study, overcomes some earlier limitations. Scale for Suicide Ideation and Compositive Interview Diagnostic Instrument data were analyzed to report on prevalence of SI and SA. Additionally, important sociodemographic, clinical, psychological, environmental, and neurobiological determinants and course of SI and SA identified in depressive and/or anxiety disorder respondents in 16 NESDA articles were summarized. Results: Within respondents with 12-month diagnosis (n=1,783), SI and 12-month SA prevalence ranged from 17.1-20.1% and 0.8-3.0% respectively across 5 waves during 9-year follow-up and SI was highly recurrent. Both SI and SA were especially associated with comorbid depression and anxiety, higher clinical severity, sleep dysfunctions, higher aggression and hopelessness, and childhood trauma. In the (neuro)biological domain, SI was linked with immune dysregulation and SA with abnormal brain activity during emotion processing and genetic risk. Limitations: Most articles were cross-sectional in nature, preventing causal inferences and no conclusions could be drawn about the overall magnitude of results. Conclusion: SI and SA are multifactorial phenomena and especially prevalent amongst comorbid depressive and anxiety respondents. Considering many overlapping SI and SA determinants, more neurobiological determinants and use of innovative methodological techniques are desirable.
KW - Anxiety Disorders/epidemiology
KW - Child
KW - Cohort Studies
KW - Cross-Sectional Studies
KW - Humans
KW - Netherlands/epidemiology
KW - Prevalence
KW - Risk Factors
KW - Suicidal Ideation
KW - Suicide, Attempted
UR - http://www.scopus.com/inward/record.url?scp=85100474269&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jad.2021.01.053
DO - https://doi.org/10.1016/j.jad.2021.01.053
M3 - Review article
C2 - 33571797
SN - 0165-0327
VL - 283
SP - 267
EP - 277
JO - Journal of affective disorders
JF - Journal of affective disorders
ER -