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Suicidal ideation in anxiety-disordered youth: a systematic review

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SUICIDAL IDEATION IN ANXIETY-DISORDERED YOUTH: A SYSTEMATIC REVIEW
Damilakou Maria, Nursing Student, National & Kapodistrian University of Athens

Introduction

Internationally, Suicidal Ideation has become an increasing public health challenge with growing incidence among youth. Research findings have implicated mental disorders among which, anxiety disorders are the most common mental health disorders and have been identified as independent predictors for suicidality.

 Aim

The purpose of this systematic review was to study the level of association between different types of anxiety disorders and suicidal ideation among youth.

Methods

A thorough literature review was conducted in electronic databases (Pubmed, Web of Science, Scopus), using adequate key words for articles investigating the correlation between anxiety disorders and suicidal ideation, published after 2000.

Results

Suicidal Ideation includes thoughts about self-destruction,  the worthlessness of life or even wishes or plans about the end of life. Therefore, is considered as one of the most powerful risk factors suicidal ideation. As it is known that 1 in 5 youngsters suffer from psychological disorders, anyone could say that adolescence has been undoubtedly a period of time, when young people feel themselves very fragile. Although it is certain that anxiety disorders strongly correlate to Suicidal Ideation, it is still controversial whether they are independently associated with suicidality or it is due to comorbidity with depressive disorders and other demographic factors.

Anxiety disorders, such as social phobia, Generalized Anxiety Disorder(GAD), Panic Disorder and Agoraphobia,  include the following symptomatology: irritability, anger outbursts, great emotionality, sleep problems, headaches or stomachaches. They are likely to redound to deterioration in social, family or academic life, disrupting at the meanwhile the personal development that takes place in youth and increasing the risk of developing other mental disorders, such as Major Depressive Disorder, or educational difficulties. So, due to the continuity of this problem and the significant impairment that it causes, adolescents may consider suicide as a means of escape from their harsh reality.

Although it may not be certain if there is indeed an independent association between Suicidal behavior and child anxiety, both early identification and successful management of the candidate disordered adolescents are the keys to the case.

At this point, the significance of primary care is exceptional. Families would easier accept help from a primary care clinician, who would be able to evaluate the severity of the anxiety or depressive  issues. Most recent researches suggest Cognitive Behavioral Therapy(CBT) as a solution to moderate anxiety combined with functional impairment, and a protective factor from Suicidal Ideation as well. The more severe incidents are suggested to follow specific medication including serotonin inhibitors(SSRI’s) and frequent evaluation. In that way, the first steps for the development of effective preventive programs could be made.

Conclusion

Overall, there is a lack of large-scale studies among clinical samples, that examine if anxiety disorders are predictors for suicidal behavior, and as a result there is mixed evidence regarding whether these two are independently associated without the presence of comorbid depressive disorders. But suggestions about future research and the configuration of preventive programs are offered.

References

Eikelenboom M.(2011).Do depression and anxiety converge or diverge in their association with suicidality? Journal of Psychiatric Research, 46, 608-615./O’neil A.K.(2012). Suicidal Ideation in Anxiety-Disordered Youth. The official journal of the American Association of suicidology, 305-317/Sakolsky D.,Birmaher B.(2008). Pediatric anxiety disorders: management in primary care. Current opinion in Pediatrics, 20, 538-543./Dugas E., Low C P N. et al(2012). Early Predictors of Suicidal Ideation in  Young Adults. The Canadian Journal of Psychiatry, Vol 57, No 7, 429-436/Naragon-Gainey K., Watson D.(2011). The anxiety disorders and suicidal ideation: accounting for co-morbidity via underlying personality traits. Psychological Medicine, 41, 1437–1447./Allan P.N.,& Capron W.D. et al(2014).Unique relations among anxiety sensitivity factors and anxiety, depression, and suicidal ideation. Journal of Anxiety Disorders 28, 266–275./ Foley L.D.,Goldston P.D. et al(2006). Proximal Psychiatric Risk Factors for Suicidality in Youth.The Great Smoky Mountains Study. Arch Gen Psychiatry, Vol 63,1017-1024.

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