Combined effects of depression and anxiety on suicide: A case-control psychological autopsy study in rural China

• Published in: Psychiatry research Vol. 271; pp. 370 - 373
• Main Authors: Zhang, Jie, Liu, Xinxia, Fang, Le
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.01.2019
• Subjects: Adolescent; Adult; Anxiety; Anxiety - epidemiology; Anxiety Disorders - epidemiology; Case-Control Studies; Case-control study; China; Depression; Depression - epidemiology; Depressive Disorder - epidemiology; Female; Humans; Male; Risk Factors; Rural Population - statistics & numerical data; Suicide; Suicide - statistics & numerical data; Young Adult; China; Depression; Case-control study; Anxiety; Suicide; China
• ISSN: 0165-1781; 1872-7123
• DOI: 10.1016/j.psychres.2018.11.010

•Most of the previous researches indicated depression and anxiety were potential risk factors for suicide. Current researches seldom take the overlap symptoms of depression and anxiety into account when investigating their effects on suicide.•This study showed that people with low depression and high anxiety, with high depression and low anxiety, with high depression and high anxiety were at 2.46, 26.32, 54.77 times more risk for suicide, compared with subjects with low depression and low anxiety.•Although depression and anxiety overlap in some dimension, they could not replace each other, and our results indicated that the combined effects of depression and anxiety might be characterized by three dimensions: cognitive disturbance, helplessness and STAI-anxiety dimension. Most of the previous researches indicated depression and anxiety were potential risk factors for suicide, and they were also highly correlated. However, few studies have explored their combined effects on suicide and the dimensions which really work. A total of 392 suicide cases aged 15–34 years and 416 community controls of the same age range were investigated. The results showed that after controlling confounding factors, people with low depression and high anxiety, with high depression and low anxiety, with high depression and high anxiety were at 2.46, 26.32, 54.77 times more risk for suicide (all P < 0.05), compared with subjects with low depression and low anxiety. Only two of seven dimensions of depression (including cognitive disturbance, helplessness, excluding anxiety dimension) and one of two dimensions of STAI anxiety (anxiety dimension, not depression dimension) were risk factors for suicide (all OR > 1). Our main findings was that combined effects of depression and anxiety on suicide were complicated, and the effects of anxiety dimension of depression and depression dimension of anxiety must be cautiously evaluated, avoiding overlapping inclusion.