SUICIDAL IDEATION IN EMERGENCY DEPARTMENT CHEST PAIN PATIENTS - PANICDISORDER A RISK FACTOR

Most patients who present to the emergency department (ED) for chest p ain do not have a cardiac disorder, Approximately 30% of noncardiac ch est pain patients suffer from panic disorder (PD), a disabling, treata ble, yet rarely detected psychiatric condition, Although still controv ersial, PD may be a risk factor for suicidal ideation and attempts. Th e prevalence of recent suicidal ideation (ie, past week) was studied i n 441 consecutive ED chest pain patients who underwent a structured ps ychiatric interview. To examine the controversial link between panic a nd suicidal behavior, logistic regression analyses were conducted in w hich current psychiatric diagnoses (Axis I) as well as pertinent medic al and demographic information were assessed as risk factors for suici dal ideation, Participants were interviewed with the Anxiety Disorders Interview Schedule-Revised to establish psychiatric diagnoses, Recent suicidal ideation (ie, past week) was assessed with question 9 of the Beck Depression Inventory, Ten percent of patients had recent suicida l ideation, Sixty percent of patients with suicidal thoughts met crite ria for PD. In the patients with PD, suicidal ideation could not be ex plained by the presence of comorbid psychiatric or medical conditions or medication. In the total sample, only diagnoses of PD (odds ratio [ OR] = 4.3; 95% confidence interval [CI], 2.09-8.82; P = .0001) and dys thymia (OR = 9.98; 95% CI, 4.00-24.8; P = .00001) were significant and independent risk factors for suicidal ideation, PD, the most common p sychiatric condition in ED chest pain patients, may be an independent risk factor for suicidal ideation, further supporting the need for rec ognition and treatment of these patients. Copyright (C) 1997 by W.B. S aunders Company.