Age Differences in Death and Suicidal Ideation in Anxious Primary Care Patients

ABSTRACT

Objectives: The objective of this study was to examine age differences in the likelihood of endorsing of death and suicidal ideation in primary care patients with anxiety disorders.

Method: Participants were drawn from the Coordinated Anxiety Learning and Management (CALM) Study, an effectiveness trial for primary care patients with panic disorder (PD), generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), and/or social anxiety disorder (SAD).

Results: Approximately one third of older adults with anxiety disorders reported feeling like they were better off dead. Older adults with PD and SAD were more likely to endorse suicidal ideation lasting at least more than half the prior week compared with younger adults with these disorders. Older adults with SAD endorsed higher rates of suicidal ideation compared with older adults with other anxiety disorders. Multivariate analyses revealed the importance of physical health, social support, and comorbid MDD in this association.

Conclusions: Suicidal ideation is common in anxious, older, primary care patients and is particularly prevalent in socially anxious older adults. Findings speak to the importance of physical health, social functioning, and MDD in this association.

Clinical Implications: When working with anxious older adults it is important to conduct a thorough suicide risk assessment and teach skills to cope with death and suicidal ideation-related thoughts.

KEYWORDS:

• Anxiety disorders
• older adults
• social anxiety
• suicide ideation

Funding

Dr. Petkus received research support from the National Institute on Aging (F31AG042218). Dr. Wetherell received research support from Forest Laboratories. Dr. Stein receives or received research support from the U.S. Department of Defense, Eli Lilly, GlaxoSmithKline, Hoffmann-La Roche, National Institutes of Health, and the U.S. Veterans Affairs Research Program; and is currently or has been a paid consultant for AstraZeneca, Avera Pharmaceuticals, BrainCells Inc, Bristol-Myers Squibb, Comprehensive NeuroScience; Eli Lilly, Forest Laboratories, GlaxoSmithKline, Hoffmann-La Roche, Jazz Pharmaceuticals, Johnson & Johnson, Mindsite, Pfizer, Sepracor, and Transcept Pharmaceuticals. Dr. Roy-Byrne receives research grant support from the National Institutes of Health; served as a paid member of advisory boards for Jazz Pharmaceuticals and Solvay Pharmaceuticals (one meeting for each); received honoraria for CME-sponsored speaking from the American Psychiatric Association, Anxiety Disorders Association of America, CME LLC, CMP Media, Current Medical Directions, Imedex, Massachusetts General Hospital Academy, and PRIMEDIA Healthcare; and served as editor in chief for Journal Watch Psychiatry (Massachusetts Medical Society) and Depression and Anxiety (Wiley-Liss, Inc.). Dr. Roy-Byrne has also served as an expert witness on multiple legal cases related to anxiety; none involving pharmaceutical companies or specific psychopharmacology issues. No other authors report financial relationships with commercial interests.

Additional information

Funding

Dr. Petkus received research support from the National Institute on Aging (F31AG042218). Dr. Wetherell received research support from Forest Laboratories. Dr. Stein receives or received research support from the U.S. Department of Defense, Eli Lilly, GlaxoSmithKline, Hoffmann-La Roche, National Institutes of Health, and the U.S. Veterans Affairs Research Program; and is currently or has been a paid consultant for AstraZeneca, Avera Pharmaceuticals, BrainCells Inc, Bristol-Myers Squibb, Comprehensive NeuroScience; Eli Lilly, Forest Laboratories, GlaxoSmithKline, Hoffmann-La Roche, Jazz Pharmaceuticals, Johnson & Johnson, Mindsite, Pfizer, Sepracor, and Transcept Pharmaceuticals. Dr. Roy-Byrne receives research grant support from the National Institutes of Health; served as a paid member of advisory boards for Jazz Pharmaceuticals and Solvay Pharmaceuticals (one meeting for each); received honoraria for CME-sponsored speaking from the American Psychiatric Association, Anxiety Disorders Association of America, CME LLC, CMP Media, Current Medical Directions, Imedex, Massachusetts General Hospital Academy, and PRIMEDIA Healthcare; and served as editor in chief for Journal Watch Psychiatry (Massachusetts Medical Society) and Depression and Anxiety (Wiley-Liss, Inc.). Dr. Roy-Byrne has also served as an expert witness on multiple legal cases related to anxiety; none involving pharmaceutical companies or specific psychopharmacology issues. No other authors report financial relationships with commercial interests.