Suicidality in Obsessive-Compulsive Disorder: Prevalence and Relation to Symptom Dimensions and Comorbid Conditions

Author(s)

Torres, Albina R. ^[1] ; Ramos-Cerqueira, Ana Teresa A. ^[1] ; Ferrao, Ygor A. ^[2] ; Fontenelle, Leonardo F. ^[3] ; do Rosario, Maria Conceicao ^[4] ; Miguel, Euripedes C. ^[5]

Affiliation

^[1] Univ Estadual Paulista, Dept Neurol Psychol & Psychiat, Botucatu Med Sch, Sao Paulo - Brazil

^[2] Methodist Univ Ctr, Porto Alegre Inst, Postgrad Dept, Porto Alegre, RS - Brazil

^[3] Univ Fed Rio de Janeiro, Anxiety & Depress Res Program, Inst Psychiat, Rio De Janeiro - Brazil

^[4] Univ Fed Sao Paulo, Child & Adolescent Psychiat Unit UPIA, Dept Psychiat & Psychol, Sao Paulo - Brazil

^[5] Univ Sao Paulo, Sch Med, Dept Psychiat, Sao Paulo - Brazil

• Document type: Journal article
• Source: JOURNAL OF CLINICAL PSYCHIATRY; v. 72, n. 1, p. 17-26, JAN 2011.
• Web of Science Citations: 59

Abstract

Background: Suicidal thoughts and behaviors, also known as suicidality, are a fairly neglected area of study in patients with obsessive-compulsive disorder (OCD). Objective: To evaluate several aspects of suicidality in a large multicenter sample of OCD patients and to compare those with and without suicidal ideation, plans, and attempts according to demographic and clinical variables, including symptom dimensions and comorbid disorders. Method: This cross-sectional study included 582 outpatients with primary OCD (DSM-IV) recruited between August 2003 and March 2008 from 7 centers of the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders. The following assessment instruments were used: the Yale-Brown Obsessive Compulsive Scale, the Dimensional Yale-Brown Obsessive Compulsive Scale, the Beck Depression and Anxiety Inventories, the Structured Clinical Interview for DSM-IV Axis I Disorders, and 6 specific questions to investigate suicidality. After univariate analyses, logistic regression analyses were performed to adjust the associations between the dependent and explanatory variables for possible confounders. Results: Thirty-six percent of the patients reported lifetime suicidal thoughts, 20% had made suicidal plans, 11% had already attempted suicide, and 10% presented current suicidal thoughts. In the logistic regression, only lifetime major depressive disorder and posttraumatic stress disorder (PTSD) remained independently associated with all aspects of suicidal behaviors. The sexual/religious dimension and comorbid substance use disorders remained associated with suicidal thoughts and plans, while impulse-control disorders were associated with current suicidal thoughts and with suicide plans and attempts. Conclusions: The risk of suicidal behaviors must be carefully investigated in OCD patients, particularly those with symptoms of the sexual/religious dimension and comorbid major depressive disorder, PTSD, substance use disorders, and impulse-control disorders. J Clin Psychiatry 2011;72(1):17-26 (C) Copyright 2011 Physicians Postgraduate Press, Inc. (AU)

• FAPESP's process: 05/55628-8 - Phenotypic, genetic, immunological and neurobiological characterization of the obsessive compulsive disorder and its implications for treatment
• Grantee: Eurípedes Constantino Miguel Filho
• Support Opportunities: Research Projects - Thematic Grants