Prevalence of suicide attempt and clinical characteristics of suicide attempters with obsessive-compulsive disorder: a report from the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS)

Dell’Osso, Bernardo; Benatti, Beatrice; Arici, C.; Palazzo, Carlotta; Altamura, Alfredo Carlo; Hollander, Eric; Fineberg, Naomi; Stein, Dan J.; Nicolini, Humberto; Lanzagorta, Nuria; Marazziti, Donatella; Pallanti, Stefano; Ameringen, Michael Van; Löchner, Christine; Karamustafalıoğlu, Oğuz; Hranov, Luchezar; Figee, Martijn; Drummond, Lynne M.; Rodriguez, Carolyn I.; Grant, John Webster; Denys, Damiaan; Menchón, José M.; Zohar, Joseph

doi:10.1017/s1092852917000177

Cited by 34 publications

(32 citation statements)

References 43 publications

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“…Four main findings emerged. First, confirming previous studies conducted in clinical and community settings [1][2][3][4][5][43][44][45][46], individuals with OCD were at significantly increased risk of suicide attempts and death by suicide compared to individuals without OCD, and the risks were more pronounced for female than male OCD sufferers, similar to the results of another Swedish study on OCD and suicide [2]. This was anticipated in relation to suicide attempts, as nonfatal suicidal behavior is known to be more common in females [28,47].…”

Section: Discussionsupporting

confidence: 84%

Genetic and environmental sources of familial coaggregation of obsessive−compulsive disorder and suicidal behavior: a population-based birth cohort and family study

et al. 2019

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Obsessive−compulsive disorder (OCD) is associated with high risk of suicide. It is yet unknown whether OCD and suicidal behaviors coaggregate in families and, if so, what are the mechanisms underlying this coaggregation. In a population-based birth cohort and family study, we linked individuals born in Sweden in 1967-2003 (n = 3,594,181) to their parents, siblings, and cousins, and collected register-based diagnoses of OCD, suicide attempts, and deaths by suicide and followed them until December 31, 2013. We also applied quantitative genetic modeling to estimate the contribution of genetic and environmental factors to the familial coaggregation of OCD and suicidal behavior. An elevated risk of suicide attempts was observed across all relatives of individuals with OCD, increasing proportionally to the degree of genetic relatedness, with odds ratios (OR) ranging from 1.56 (95% confidence interval (CI) 1.49-1.63) in parents to 1.11 (95% CI 1.07-1.16) in cousins. The risk of death by suicide also increased alongside narrowing genetic distance, but was only significant in parents (OR 1.55; 95% CI 1.40-1.72) and full siblings (OR 1.80; 95% CI 1.43-2.26) of individuals with OCD. Familial coaggregation of OCD and suicide attempts was explained by additive genetic factors (60.7%) and non-shared environment (40.4%), with negligible contribution of shared environment. Similarly, familial coaggregation with death by suicide was attributed to additive genetics (65.8%) and nonshared environment (34.2%). Collectively, these observations indicate that OCD and suicidal behaviors coaggregate in families largely due to genetic factors. The contribution of unique environment is also considerable, providing opportunities to target high-risk groups for prevention and treatment.

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Section: Discussionsupporting

confidence: 84%

Genetic and environmental sources of familial coaggregation of obsessive−compulsive disorder and suicidal behavior: a population-based birth cohort and family study

et al. 2019

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“…The observed increase of attempted and completed suicide in prospective studies, especially the one from Fernandez et al 2017, is comparable to the reports from previous crosssectional and retrospective studies: Data from 3711 adult patients with primary OCD that came from several countries indicated that suicidal ideation within the last month was reported by 6.4% (n = 200) of patients with OCD and a lifetime history of suicide attempt was observed in 9.0% (n = 314) (Brakoulias et al 2017). In agreement, patients with a previous suicide attempt had significantly higher rates of comorbid psychiatric disorders (Dell'Osso et al 2017). This data were supported by the studies reviewed by Angelakis et al (2015).…”

Section: Outcome Of Literature Searchsupporting

confidence: 81%

Increased Risk of Attempted and Completed Suicide in Obsessive Compulsive Disorder: A Systematic Review of Follow-up Studies

Heun

2018

Global Psychiatry

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Obsessive compulsive disorder (OCD) is a severe, often long-term mental disorder. It may be independent from, or comorbid with other mental disorders, especially depression and anxiety disorders. Suicidal thoughts, ideations and ruminations are prevalent in subjects with OCD, but it is not yet clear if the incidences of attempted and completed suicides have increased in comparison with the general population and with other psychiatric disorders.MethodsWe conducted a systematic literature search on the incidence of suicide attempts and completed suicides in subjects with OCD. Search terms for Pubmed and Medline were OCD and suicide. We selected papers providing follow-up data on the incidence of attempted and completed suicide in OCD.Results404 papers were initially identified. Only 8 papers covering six studies provided prospective data on attempted or completed suicide over a defined period in subjects with OCD, four studies included control subjects. Two studies providing follow-up data were limited to high-risk samples and did not provide enough data on the incidence of suicide in comparison with the general population. The conclusion that there is an increased risk of attempted and completed suicides in OCD can only be based on one large Swedish National Registry sample with an up to 44 year follow up. Psychiatric comorbidity is the most relevant risk factor for suicide.ConclusionsEven though some studies report an increased incidence of attempted and completed suicides in OCD patients from selected high risk samples, the evidence from population based studies is mostly based on one large Swedish study. More long-term studies in the general population with a reduced risk of subject attrition are needed. Using a clear definition and assessment of suicidal behaviour and a common time-frame would improve the comparability of future studies.

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“…44 In a multicenter study, the rate of suicide attempts was 14.6% in OCD patients. 45 We found lifetime suicide attempts to be 17.9% in OCD patients. We also found suicidal thoughts and lifetime suicide attempts to be significantly higher in the OCD group than the controls.…”

Section: Discussionmentioning

confidence: 75%

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

Demirkol

Namlı

Davul³

et al. 2019

NDT

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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.

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Prevalence of suicide attempt and clinical characteristics of suicide attempters with obsessive-compulsive disorder: a report from the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS)

Cited by 34 publications

References 43 publications

Genetic and environmental sources of familial coaggregation of obsessive−compulsive disorder and suicidal behavior: a population-based birth cohort and family study

Genetic and environmental sources of familial coaggregation of obsessive−compulsive disorder and suicidal behavior: a population-based birth cohort and family study

Increased Risk of Attempted and Completed Suicide in Obsessive Compulsive Disorder: A Systematic Review of Follow-up Studies

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

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