Suicide in patients treated for obsessive-compulsive disorder: a prospective follow-up study

J Affect Disord. 2010 Aug;124(3):300-8. doi: 10.1016/j.jad.2009.12.001. Epub 2010 Jan 13.

Abstract

Background: To describe the occurrence of persistent suicidal ideation and suicide attempts in a sample of obsessive-compulsive patients followed-up prospectively during 1 to 6years, and to determine the existence of predictors of suicide behavior.

Method: Two hundred and eighteen outpatients with DSM-IV OCD, recruited from a specialized OCD Unit in Barcelona, Spain, between February 1998 and December 2007, were included in the study. Suicide ideation was assessed by item 3 of the Hamilton Depression Rating Scale. Suicide attempts were evaluated by the Beck Suicide Intent Scale. Patients with and without persistent suicidal thoughts and suicide attempters and non-attempters were compared on sociodemographic and clinical variables. A Cox proportional hazards regression analysis was used to estimate potential predictors of suicide.

Results: Patients completed a mean follow-up period of treatment of 4.1years (SD: 1.7; range: 1-6years). During this period, eighteen patients (8.2%) reported persistent suicidal ideation, two patients (0.91%) committed suicide and 11 (5.0%) attempted suicide. Being unmarried, presenting higher basal scores in the HDRS, current or previous history of affective disorders and symmetry/ordering obsessions were independently associated with suicidal behaviors.

Limitations: Patients were recruited from a specialized OCD clinic and received exhaustive treatment. Influence of variables including social support, life events, hopelessness and substance abuse/dependence was not assessed.

Conclusions: Suicide behavior is not a highly common phenomenon in OCD, but it should not be disregarded, especially in unmarried patients, with comorbid depression and symmetry/ordering obsessions and compulsions, who appear to be at a greater risk for suicide acts.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cognitive Behavioral Therapy
  • Combined Modality Therapy
  • Comorbidity
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Mood Disorders / epidemiology
  • Mood Disorders / psychology
  • Mood Disorders / therapy
  • Obsessive-Compulsive Disorder / epidemiology
  • Obsessive-Compulsive Disorder / psychology*
  • Obsessive-Compulsive Disorder / therapy*
  • Personality Disorders / epidemiology
  • Personality Disorders / psychology
  • Personality Disorders / therapy
  • Personality Inventory / statistics & numerical data
  • Prospective Studies
  • Psychometrics
  • Risk Factors
  • Serotonin Uptake Inhibitors / therapeutic use
  • Suicide / psychology*
  • Suicide / statistics & numerical data*
  • Suicide, Attempted / psychology*
  • Suicide, Attempted / statistics & numerical data*
  • Young Adult

Substances

  • Serotonin Uptake Inhibitors