PANIC-ASSOCIATED SUICIDAL AND AGGRESSIVE IDEATION AND BEHAVIOR

Some investigators have noted an increased incidence of suicidal ideat ion and attempts in individuals with panic attacks. The direct tempora l relationship between the panic stale and suicidal thoughts and behav iors has not been well elucidated however. Furthermore, although aggre ssive behavior is often manifested in individuals with suicidal behavi or, the relationship between aggression and panic has received little attention. The aim of this study was to assess the frequency and type of reported suicidal and aggressive ideation and behaviors that occur during the panic state in patients with panic disorder. In order to ev aluate the contribution of depression, individuals with pure (i.e. unc omplicated) panic disorder were compared with individuals who had como rbid panic and major depression. Nineteen patients with a diagnosis of pure panic disorder and 28 patients with comorbid panic plus major de pression were included in the study. All patients were given the Panic , Suicide and Aggression Scale (PSAS), a questionnaire specifically de signed to assess reported suicidal and aggressive thoughts and behavio rs that occur during panic attacks. Other scales given to all patients included overall measures of impulsivity, suicide risk and violence r isk. Patients with pure panic disorder reported high rates of suicidal and aggressive ideation and behavior during panic. The presence of co morbid depression resulted in a doubling of the rate of reported panic -associated suicidal ideation, property destruction and assaults, and a five-fold increase in the rate of homicidal ideation. The rate of re ported suicide attempts was equal in the pure panic and comorbid group . There were also high correlations in all panic patients between meas ures of panic associated suicide and aggression with the psychometric measures of impulsivity, suicide risk and violence risk. (C) 1997 Else vier Science Ltd.