The suicidality continuum in a large sample of obsessive-compulsive disorder (OCD) patients.
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.
['Velloso|P|P|', 'Piccinato|C|C|', 'Ferrão|Y|Y|', 'Aliende Perin|E|E|', 'Cesar|R|R|', 'Fontenelle|L|L|', 'Hounie|A G|AG|', 'do Rosário|M C|MC|']
D000328:Adult D001007:Anxiety D001938:Brazil D015897:Comorbidity D003430:Cross-Sectional Studies D039721:Diagnostic and Statistical Manual of Mental Disorders D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D009771:Obsessive-Compulsive Disorder D015995:Prevalence D011788:Quality of Life D059020:Suicidal Ideation D013405:Suicide D013406:Suicide, Attempted
Suicidality OCD Quality of life