<p>Psychache and Suicidal History in Patients with Obsessive-Compulsive Disorder</p>

Abstract

Purpose: Suicide is an important cause of death in patients diagnosed with obsessivecompulsive disorder (OCD) as well as other psychiatric disorders. Early determining of risk factors provides an opportunity for intervention. The mediating effect of psychological pain (also known as psychache) on suicide has been shown in various disorders but has not been investigated in patients with OCD. In this study, we aimed to show the relationship between psychological pain and other clinical variables and suicide in OCD patients. Patients and methods: This cross-sectional study consisted of 67 patients diagnosed with OCD according to DSM-5 criteria with no comorbid psychiatric diagnosis who applied to the psychiatric outpatient clinic of Çukurova University Faculty of Medicine and 63 healthy controls. Among the OCD patients, 12 had previous suicide attempts. In addition to the sociodemographic data form, participants filled out the Yale-Brown Obsessive Compulsive Scale (YBOCS), the Psychache Scale (PS), the Beck Scale for Suicidal Ideation (BSIS), and the Hamilton Depression Scale (HDS). Results: OCD group's median obsession, compulsion, and the total scores of YBOCS, and the mean PS scores were higher than the control group. There was no difference between the sociodemographic variables of OCD patients with and without previous suicide attempts such as age, gender, years of education, place of residence, marital, and occupational status. The median scores of obsession, avoidance, global severity, and indecisiveness subdimensions of YBOCS, the mean BSIS and PS scores, the rates of current aggressive, current contamination, and the past religious obsessions were higher in the suicidal group. There were moderately significant relationships in the same direction between the PS, BSIS, and total YBOCS scores. Multivariate regression analysis demonstrated that only the PS scores predicted previous suicide attempts. Conclusion: Our results demonstrated that current aggressive, current contamination, past religious obsessions, and the higher psychological pain are related to previous suicide attempts in OCD patients. Our regression analysis supports Shneidman's hypothesis: there would be no suicide without psychache. Relieving psychache in OCD patients may reduce suicide attempts even if there is no diagnosis of comorbid depression.

Research on Psychache in Suicidal Population: A Bibliometric and Visual Analysis of Papers Published During 1994–2020

“…A cross-sectional study by Demirkol et al (54) demonstrated that psychache might be positively associated with suicide attempts and occurrent suicidal thoughts, and alexithymia might be related to the negative symptom of schizophrenia and psychache in patients with a diagnosis of schizophrenia. Similarly, among the patients with obsessive-compulsive disorder (OCD), a strong correlation was found between psychache and previous suicide attempt (55). Psychache has also been shown to mediate the relationships between suicidal factors and other variables.…”

Effect of Perceived Social Support on Psychache: Mediating Effect of Psychological Resilience

“…Suicide will not occur without psychache. Relieving the psychache of patients with obsessive–compulsive disorder can decrease the intentions of suicide, even though comorbid depression is not diagnosed ( 7 ). External factors (e.g., family, school, and society) and internal factors (e.g., physiology and psychology) can influence psychache, and seeking social support can positively relieve psychache ( 8 ).…”

Chronic severe methanol intoxication after repeated mask cleansing due to fear of COVID‐19: A new risk of coronaphobia

“…Although basal ganglia injury may induce an abnormal behavior with obsessive−compulsive traits [15,16] in this patient the opposite was more likely: her repeated cleansing action resulted in toxic basal ganglia damage.…”