An even more important limitation of the literature on this topic is that most studies, with the exception of a few,23,31 have used cross-sectional, retrospective data. Such retrospective reports have been criticized for the lack of temporal information on whether anxiety disorders preceded the onset of suicidal behavior24 among those with comorbidity. Prospective longitudinal evaluation of whether anxiety disorders are risk factors for new-onset suicidal behavior is required.
The current study addresses whether anxiety disorders have a significant impact on suicidal behavior using data from the Netherlands Mental Health and Incidence Survey (NEMESIS),32,33 a large, Dutch, general population survey. We examined the impact of anxiety disorders on suicidal behavior in 2 stages. First, we estimated whether the presence of lifetime anxiety disorder diagnoses had a cross-sectional association with lifetime suicidal behavior at baseline assessment. Second, we examined whether anxiety disorders at baseline had a significant impact on first-ever incidence of SI and SAs at follow-up assessments. To the best of our knowledge, this represents the first prospective examination of whether anxiety disorders predict subsequent onset of suicidal behavior in a large population-based sample.