Anxiety disorders, comorbidity, and suicide attempts in adolescence: a preliminary investigation

The prevalence of anxiety disorders and associated DSM-III-R diagnoses were measured in a sample of 80 female adolescents aged between 15 to 20 years consulting an outpatient psychiatric service for adolescents. The suicide a ttempt group (SA) included 40 patients evaluated within 24 h after attempte d suicide;This is compared to 40 consecutive patients consulting the same c enter but without any history of suicide attempt(the no attempt group, NA). The global prevalence of anxiety disorders was similar in both groups (SA: 65% vs. NA: 60%, NS) as was the relative importance of the different disor ders in each group, generalized anxiety being the most frequent specific an xiety disorder. The most striking difference between the two groups was in the prevalence of affective disorders in 90% (SA) vs. 32.5% (NA) (P < 0.001 ), leading to high rates of comorbidity on axis I in the SA group. Of the 2 4 patients with anxiety disorders who attempted suicide, 21 (95%) fulfilled criteria for associated major depression,compared to five out of 21 (24%) patients with anxiety disorders who had not attempted suicide. Adolescents with anxiety disorders developing major depression are at a hig h risk for suicide. The depression may be of short duration (less than two weeks) when compared to that of the anxiety disorder (greater than six mont hs). To improve suicide prevention, our findings if confirmed should encour age clinicians to perform a close follow-up of adolescents with anxiety dis orders for an early detection of sudden depressive breakdowns. (C) 1999 Els evier, Paris.