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


METHODS
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.


CONCLUSIONS
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.
Alonso
P
P
OCD Clinical and Research Unit, Department of Psychiatry, Bellvitge University Hospital, 08907 L'Hospitalet de Llobregat, Barcelona, Spain. mpalonso@bellvitgehospital.cat
Segalàs
C
C
Real
E
E
Pertusa
A
A
Labad
J
J
Jiménez-Murcia
S
S
Jaurrieta
N
N
Bueno
B
B
Vallejo
J
J
Menchón
J M
JM
D000293:Adolescent; D000328:Adult; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D009771:Obsessive-Compulsive Disorder / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D010554:Personality Disorders / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D010555:Personality Inventory / Q000706:statistics & numerical data; D011446:Prospective Studies; D011594:Psychometrics; D012307:Risk Factors; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data*; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data*; D055815:Young Adult
D017367:Selective Serotonin Reuptake Inhibitors