Ruiying Chen , Yan Chen , Yanzhi Li , Wenjing Zhou , Wenjian Lai , Subinuer Yiming , Qindan Zhang , Chengxi Wen , Yuhua Liao , Huimin Zhang , Yifeng Liu , Wanxin Wang , Lan Guo , Ciyong Lu , Xue Han
{"title":"Anxiety symptom trajectories and subsequent suicidal ideation among patients with major depressive disorder: A longitudinal study in China","authors":"Ruiying Chen , Yan Chen , Yanzhi Li , Wenjing Zhou , Wenjian Lai , Subinuer Yiming , Qindan Zhang , Chengxi Wen , Yuhua Liao , Huimin Zhang , Yifeng Liu , Wanxin Wang , Lan Guo , Ciyong Lu , Xue Han","doi":"10.1016/j.jad.2025.119704","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>To examine the longitudinal associations between different anxiety symptom trajectories and subsequent suicidal ideation (SI) among patients with major depressive disorder (MDD).</div></div><div><h3>Methods</h3><div>We used data from patients with MDD in the Depression Cohort in China. At baseline, 4, 8, and 12 weeks, anxiety symptoms were assessed using the Generalized Anxiety Disorder 7-item Scale, and trajectories were identified using latent class trajectory models. At 12, 24, and 48 weeks, SI was assessed using the Beck Scale for Suicide Ideation.</div></div><div><h3>Results</h3><div>We included 718 participants with a median (IQR) age of 26.0 (22.3, 31.0) years, among whom 489 (68.1 %) were female. Five trajectories of anxiety symptoms were identified: persistent mild (25.1 %), rapidly decreasing (30.1 %), persistent moderate (21.7 %), slowly decreasing (10.3 %), and persistent severe (12.8 %). Compared to the persistent mild anxiety symptom trajectory, the rapidly decreasing anxiety symptom trajectory was significantly associated with lower levels of SI (<em>β</em> coefficient, −0.186; 95 % confidence interval [CI], −0.296 to −0.075). Conversely, the persistent moderate anxiety symptom trajectory (<em>β</em> coefficient, 0.126; 95 % CI, 0.03 to 0.249) and persistent severe anxiety symptom trajectory (<em>β</em> coefficient, 0.334; 95 % CI, 0.185 to 0.482) were associated with higher levels of SI. No statistically significant association was found for the slowly decreasing anxiety symptom trajectory (<em>β</em> coefficient, 0.051; 95 % CI, −0.101 to 0.202).</div></div><div><h3>Limitations</h3><div>Reporting bias; Selection bias; Observational design; Generalizability.</div></div><div><h3>Conclusions</h3><div>Among patients with MDD, achieving reductions in anxiety symptoms may mitigate suicidal risk, and attention should be paid to the suicidal risk associated with anxiety symptoms, particularly when symptoms remain severe in the longitudinal follow-up.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"389 ","pages":"Article 119704"},"PeriodicalIF":4.9000,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of affective disorders","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0165032725011462","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background
To examine the longitudinal associations between different anxiety symptom trajectories and subsequent suicidal ideation (SI) among patients with major depressive disorder (MDD).
Methods
We used data from patients with MDD in the Depression Cohort in China. At baseline, 4, 8, and 12 weeks, anxiety symptoms were assessed using the Generalized Anxiety Disorder 7-item Scale, and trajectories were identified using latent class trajectory models. At 12, 24, and 48 weeks, SI was assessed using the Beck Scale for Suicide Ideation.
Results
We included 718 participants with a median (IQR) age of 26.0 (22.3, 31.0) years, among whom 489 (68.1 %) were female. Five trajectories of anxiety symptoms were identified: persistent mild (25.1 %), rapidly decreasing (30.1 %), persistent moderate (21.7 %), slowly decreasing (10.3 %), and persistent severe (12.8 %). Compared to the persistent mild anxiety symptom trajectory, the rapidly decreasing anxiety symptom trajectory was significantly associated with lower levels of SI (β coefficient, −0.186; 95 % confidence interval [CI], −0.296 to −0.075). Conversely, the persistent moderate anxiety symptom trajectory (β coefficient, 0.126; 95 % CI, 0.03 to 0.249) and persistent severe anxiety symptom trajectory (β coefficient, 0.334; 95 % CI, 0.185 to 0.482) were associated with higher levels of SI. No statistically significant association was found for the slowly decreasing anxiety symptom trajectory (β coefficient, 0.051; 95 % CI, −0.101 to 0.202).
Among patients with MDD, achieving reductions in anxiety symptoms may mitigate suicidal risk, and attention should be paid to the suicidal risk associated with anxiety symptoms, particularly when symptoms remain severe in the longitudinal follow-up.
期刊介绍:
The Journal of Affective Disorders publishes papers concerned with affective disorders in the widest sense: depression, mania, mood spectrum, emotions and personality, anxiety and stress. It is interdisciplinary and aims to bring together different approaches for a diverse readership. Top quality papers will be accepted dealing with any aspect of affective disorders, including neuroimaging, cognitive neurosciences, genetics, molecular biology, experimental and clinical neurosciences, pharmacology, neuroimmunoendocrinology, intervention and treatment trials.