Hostname: page-component-5cf477f64f-fcbfl Total loading time: 0 Render date: 2025-04-02T21:27:07.090Z Has data issue: false hasContentIssue false
  • English
  • Français

The suicidality continuum in a large sample of obsessive–compulsive disorder (OCD) patients

Published online by Cambridge University Press:  23 March 2020

P. Velloso ,
C. Piccinato ,
Y. Ferrão ,
E. Aliende Perin ,
R. Cesar ,
L. Fontenelle ,
A.G. Hounie  and
M.C. do Rosário
P. Velloso*
Affiliation:
Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil Obsessive-Compulsive Spectrum Disorder Research Consortium (C-TOC), Brazil
C. Piccinato
Affiliation:
Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil Obsessive-Compulsive Spectrum Disorder Research Consortium (C-TOC), Brazil
Y. Ferrão
Affiliation:
Obsessive-Compulsive Spectrum Disorder Research Consortium (C-TOC), Brazil Department of Psychiatry, Health Sciences Federal University of Porto Alegre, Porto Alegre, Brazil
E. Aliende Perin
Affiliation:
Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil Obsessive-Compulsive Spectrum Disorder Research Consortium (C-TOC), Brazil
R. Cesar
Affiliation:
Obsessive-Compulsive Spectrum Disorder Research Consortium (C-TOC), Brazil
L. Fontenelle
Affiliation:
Obsessive-Compulsive Spectrum Disorder Research Consortium (C-TOC), Brazil Department of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
A.G. Hounie
Affiliation:
Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil Obsessive-Compulsive Spectrum Disorder Research Consortium (C-TOC), Brazil
M.C. do Rosário
Affiliation:
Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil Obsessive-Compulsive Spectrum Disorder Research Consortium (C-TOC), Brazil
*
*Corresponding author at: Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil. Tel.: +55 11 5576 4990; fax: +55 11 5576 4990. E-mail address:[email protected](P. Velloso).
Get access

Abstract

Background

Obsessive–compulsive disorder (OCD) has a chronic course leading to huge impact in the patient’s functioning. Suicidal thoughts and attempts are much more frequent in OCD subjects than once thought before.

Aim

To empirically investigate whether the suicidal phenomena could be analyzed as a suicidality severity continuum and its association with obsessive–compulsive (OC) symptom dimensions and quality of life (QoL), in a large OCD sample.

Methods

Cross-sectional study with 548 patients diagnosed with OCD according to the DSM-IV criteria, interviewed in the Brazilian OCD Consortium (C-TOC) sites. Patients were evaluated by OCD experts using standardized instruments including: Yale-Brown Obsessive–Compulsive Scale (YBOCS); Dimensional Yale-Brown Obsessive–Compulsive Scale (DYBOCS); Beck Depression and Anxiety Inventories; Structured Clinical Interview for DSM-IV (SCID); and the SF-36 QoL Health Survey.

Results

There were extremely high correlations between all the suicidal phenomena. OCD patients with suicidality had significantly lower QoL, higher severity in the “sexual/religious”, “aggression” and “symmetry/ordering” OC symptom dimensions, higher BDI and BA scores and a higher frequency of suicide attempts in a family member. In the regression analysis, the factors that most impacted suicidality were the sexual dimension severity, the SF-36 QoL Mental Health domain, the severity of depressive symptoms and a relative with an attempted suicide history.

Conclusions

Suicidality could be analyzed as a severity continuum and patients should be carefully monitored since they present with suicidal ideation. Lower QoL scores, higher scores on the sexual dimension and a family history of suicide attempts should be considered as risk factors for suicidality among OCD patients.

Keywords

SuicidalityQuality of lifeOCD
Type
Original article
Information
European Psychiatry , Volume 38 , October 2016 , pp. 1 - 7
Copyright
Copyright © Elsevier Masson SAS 2016

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association, Diagnostic and statistical manual of mental disorders (DSM5). 5th ed.Washington, DC: American Psychiatric Press;2013CrossRefGoogle Scholar
Ruscio, AMStein, DJChiu, WTKessler, RCThe epidemiology of Obsessive–Compulsive disorder in the National Comorbidity Survey Replication. J Mol Psychiatry. 2010;15:53–63CrossRefGoogle ScholarPubMed
Jacoby, RJLeonard, RCRiemann, BCAbramowitz, JSPredictors of quality of life and functional impairment in obsessive–compulsive disorder. Compr Psychiatry. 2014;55:1195–1202CrossRefGoogle ScholarPubMed
Akdede, BAlptekin, KAkvardar, Yet al.Quality of life in patients with obsessive–compulsive disorder: relations with cognitive functions and clinical symptoms. Turk J Psychiatry. 2005;16:1–7Google Scholar
Angst, JGamma, AEndrass, Jet al.Obsessive–compulsive severity spectrum in the community: prevalence, comorbidity, and course. Eur Arch of Psychiatry Clin Neurosci. 2004;254:156–164CrossRefGoogle ScholarPubMed
Steketee, GDisability and family burden in obsessive–compulsive disorder. Can J Psychiatry. 1997;42:919–928CrossRefGoogle ScholarPubMed
Bobes, JGonzález, MPBascarán, MTArango, CSáiz, PABousoño, MQuality of life and disability in patients with obsessive–compulsive disorder. Eur Psychiatry. 2001;16:239–245CrossRefGoogle ScholarPubMed
Koran, LMQuality of life in obsessive–compulsive disorder. Psychiatr Clin North Am. 2000;23:509–517CrossRefGoogle ScholarPubMed
Tenney, NHDenys, DAVan Megen, HJet al.Effect of a pharmacological intervention on quality of life in patients with obsessive–compulsive disorder. Int Clin Psychopharmacol. 2003;18:29–33Google ScholarPubMed
Niederauer, KGBraga, DTSouza, FPMeyer, ECordioli, AVQuality of life in individuals with obsessive–compulsive disorder: a review. Rev Bras Psiquiatr. 2007;29:271–278CrossRefGoogle ScholarPubMed
Moritz, SRufer, MFricke, Set al.Quality of life in obsessive–compulsive disorder before and after treatment. Compr Psychiatry. 2005;46:453–459CrossRefGoogle ScholarPubMed
Macy, ASTheo, JNKaufmann, SCet al.Quality of life in Obsessive–Compulsive disorder. CNS Spectr. 2013;18:21–33CrossRefGoogle ScholarPubMed
Subramaniam, MSoh, PVaingankar, JAPicco, LChong, SAQuality of life in obsessive–compulsive disorder: impact of the disorder and of treatment. CNS Drugs. 2013;27:367–383CrossRefGoogle Scholar
Kouzis, ACEaton, WWPsychopathology and the initiation of disability payments. Psychiatr Serv. 2000;51:908–913CrossRefGoogle ScholarPubMed
Koran, LMThienemann, MLDavenport, RQuality of life for patients with obsessive–compulsive disorder. Am J Psychiatry. 1996;153:783–788Google ScholarPubMed
Eisen, JLMancebo, MAPinto, Aet al.Impact of obsessive–compulsive disorder on quality of life. Compr Psychiatry. 2006;47:270–275CrossRefGoogle ScholarPubMed
Torres, ARRamos-Cerqueira, A.T.D.A.Torresan, RCDomingues, MDSHercos, ACRGuimaraes, ABCPrevalence and associated factors for suicidal ideation and behaviors in obsessive–compulsive disorder. CNS Spectrums. 2007;12:771–778CrossRefGoogle ScholarPubMed
Torres, ARPrince, MJBebbington, PEet al.Obsessive–compulsive disorder: prevalence, comorbidity, impact, and help-seeking in the British National Psychiatric Morbidity Survey of 2000. Am J Psychiatry. 2006;163:1978–1985CrossRefGoogle ScholarPubMed
Khan, ALeventhal, RMKhan, SBrown, ASuicide risk in patients with anxiety disorders: a meta-analysis of the FDA database. J Affect Disord. 2002;68:183–190CrossRefGoogle ScholarPubMed
Kamath, PReddy, YCJKandavel, TSuicidal behavior in obsessive–compulsive disorder. J Clin Psychiatry. 2007;68:1741–1750CrossRefGoogle ScholarPubMed
Alonso, PSegalas, CReal, Eet al.Suicide in patients treated for obsessive–compulsive disorder: a prospective follow-up study. J Affect Disord. 2010;124:300–308CrossRefGoogle ScholarPubMed
Torres, ARRamos-Cerqueira, ATAFerrão, YAet al.Suicidality in obsessive–compulsive disorder: prevalence and relation to symptom dimensions and comorbid conditions. J Clin Psychiatry. 2011;72:17–26CrossRefGoogle ScholarPubMed
Angelakis, IGooding, PTarrier, Net al.Suicidality in obsessive–compulsive disorder (OCD): a systematic review and meta-analysis. Clin Psychol Rev. 2015;39:1–15CrossRefGoogle ScholarPubMed
Torres, ARShavitt, RGTorresan, RCFerrao, YAMiguel, ECFontenelle, LFClinical features of pure obsessive–compulsive disorder. Compr Psychiatry. 2013;54:1042–1052CrossRefGoogle ScholarPubMed
Fineberg, NAHengartner, MPBergbaum, Cet al.Lifetime comorbidity of obsessive–compulsive disorder and sub-threshold Obsessive–Compulsive symptomatology in the community: impact, prevalence, sociodemographic and clinical characteristics. Int J Psychiatry Clin Pract. 2013;17:188–196CrossRefGoogle Scholar
Fontenelle, LFCocchi, LHarrison, BJet al.Towards a post-traumatic subtype of obsessive–compulsive disorder. J Anxiety Disord. 2012;26:377–383CrossRefGoogle ScholarPubMed
Hung, TCTang, HSChiu, CHChen, YYChou, KRChiou, HCet al.Anxiety, depressive symptom and suicidal ideation of outpatients with obsessive–compulsive disorders in Taiwan. J Clin Nurs. 2010;19:3092–3101CrossRefGoogle ScholarPubMed
Balci, VSevincok, LSuicidal ideation in patients with obsessive–compulsive disorder. Psychiatry Res. 2010;175:104–108CrossRefGoogle ScholarPubMed
Dell’osso, LCasu, GCarlini, MConversano, Cet al.Sexual obsessions and suicidal behaviors in patients with mood disorders, panic disorder and schizophrenia. Ann Gen Psychiatry. 11 2012 27CrossRefGoogle Scholar
Hollander, EKwon, KWon, JHet al.Obsessive–compulsive and spectrum disorders: overview and quality of life issues. J Clin Psychiatry. 1996;57:3–6Google ScholarPubMed
Sareen, JCox, BJAfifi, TOet al.Anxiety disorders and risk for suicidal ideation and suicide attempts: a population based longitudinal study of adults. Arch Gen Psychiatry. 2005;62:1249–1257CrossRefGoogle ScholarPubMed
Scocco, PDe Girolamo, GVilagut, Get al.Prevalence of suicide ideation, plans, and attempts and related risk factors in Italy: results from the European Study on the Epidemiology of Mental Disorders—World Mental Health study. Compr Psychiatry. 2008;49:13–21CrossRefGoogle Scholar
Bertolote, JMFleischmann, ADe Leo, Det al.Suicide attempts, plans, and ideation in culturally diverse sites: the WHO SUPRE-MISS community survey. Psychol Med. 2005;35:1457–1465CrossRefGoogle ScholarPubMed
Paykel, ESMyers, JKLindenthal, JJTanner, JSuicidal feelings in the general population: a prevalence study. Br J Psychiatry. 1974;124:460–469CrossRefGoogle ScholarPubMed
Storch, EABussing, RJacob, MLet al.Frequency and correlates of suicidal ideation in pediatric obsessive–compulsive disorder. Child Psychiatry Hum Dev. 2015;46:75–83CrossRefGoogle ScholarPubMed
Raines, AMCapron, DWBontempo, ACDane, BFSchmidt, NBObsessive–Compulsive symptom dimensions and suicide: the moderating role of anxiety sensitivity cognitive concerns. Cogn Ther Res. 2014;38:660–669CrossRefGoogle Scholar
Gupta, MGiridhar, CKulhara, PBurden of care of neurotic patients: correlates and coping strategies in relatives. Indian J Soc Psychiatry. 1991;7:8–21Google Scholar
Dhyani, MTrivedi, JKNischal, Aet al.Suicidal behavior of Indian patients with obsessive–compulsive disorder. Indian J Psychiatry. 2013;55:161–166Google ScholarPubMed
Miguel, ECFerrão, YARosário, MCet al.Brazilian Research Consortium on obsessive–compulsive spectrum disorders. Rev Bras Psiquiatr. 2008;30:185–196CrossRefGoogle Scholar
First, MBSpitzer, RLGibbon, MWilliams, JBStructured clinical interview for DSM-IV axis I disorders: clinical version (SCID-CV). Washington, DC: American Psychiatric Press; 1997Google Scholar
Kaufman, JBirmaher, BBrent, Det al.Schedule for Affective Disorders and Schizophrenia for School-Aged Children – Present and Lifetime (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psych. 1997;36:980–988CrossRefGoogle Scholar
Goodman, WKPrice, LHRasmussen, SAet al.The Yale-Brown Obsessive–Compulsive Scale. II. Validity. Arch Gen Psychiatry. 1989;46:1012–1016CrossRefGoogle ScholarPubMed
Asbahr, FRLotufo, NFTurecki, GX et al. Escala Yale-Brown de Sintomas Obsessivo-Compulsivos, tradução brasileira. In: Miguel EC. Transtornos do espectro obsessivo-compulsivo, Rio de Janeiro, Guanabara-Koogan; 1996; 219–230.Google Scholar
Rosario-Campos, MCMiguel, ECQuatrano, Set al.The Dimensional Yale-Brown Obsessive–Compulsive Scale (DYBOCS): an instrument for assessing obsessive-compulsive symptom dimensions. Mol Psychiatry. 2006;11:495–504CrossRefGoogle Scholar
Beck, ATWard, CHMendelson, Met al.An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561–571CrossRefGoogle ScholarPubMed
Beck, ATEpstein, NBrown, Get al.An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988;56:893–897CrossRefGoogle ScholarPubMed
Gorenstein, CAndrade, LValidation of a Portuguese version of the Beck Depression Inventory and the State-Trait Anxiety Inventory in Brazilian subjects. Braz J Med Biol Res. 1996;29:453–457Google ScholarPubMed
Ware, JE Jr.Sherbourne, CDThe MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30:473–483CrossRefGoogle ScholarPubMed
Ciconelli, RMFerraz, MBSantos, WMeinão, IQuaresma, MRTradução para a língua portuguesa e validação do questionário genérico de avaliação de qualidade de vida SF-36 (Brasil SF-36)/Brazilian-Portuguese version of the SF-36. A reliable and valid quality of life outcome measure. Rev Bras Reumatol. 1999;39:143–150Google Scholar
Borges, GNock, MKHaro Abad, JMet al.Twelve-month prevalence of and risk factors for suicide attempts in the World Health Organization World Mental Health Surveys. J Clin Psychiatry. 2010;71:1617–1628CrossRefGoogle ScholarPubMed
World Health Organization, Preventing suicide: a global imperative. Geneva, Switzerland: WHO; 2014Google Scholar
Fawzy, NNashim, HPrevalence and risk factors of suicide among patients with obsessive–compulsive disorder. Middle East Curr Psychiatry. 2010;18:18–22CrossRefGoogle Scholar
Kanwar, AMalik, SProkop, LJSim, LAFeldstein, DWang, Zet al.The association between anxiety disorders and suicidal behaviors: a systematic review and meta-analysis. Depress Anxiety. 2013;30:917–929Google ScholarPubMed
Chakraborty, VCherian, AVMath, SBet al.Clinically significant hoarding in obsessive–compulsive disorder: results from an Indian study. Compr Psychiatry. 2012;53:1153–1160CrossRefGoogle ScholarPubMed
Maris, RWPathways to suicide. Baltimore: Johns Hopkins University Press; 1981Google Scholar
Submit a response

Comments

No Comments have been published for this article.