title: Suicidality in obsessive-compulsive disorder: prevalence and relation to symptom dimensions and comorbid conditions.
abstract: BACKGROUND
  Suicidal thoughts and behaviors, also known as suicidality, are a fairly neglected area of study in patients with obsessive-compulsive disorder (OCD).
  
  
  OBJECTIVE
  To evaluate several aspects of suicidality in a large multicenter sample of OCD patients and to compare those with and without suicidal ideation, plans, and attempts according to demographic and clinical variables, including symptom dimensions and comorbid disorders.
  
  
  METHODS
  This cross-sectional study included 582 outpatients with primary OCD (DSM-IV) recruited between August 2003 and March 2008 from 7 centers of the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders. The following assessment instruments were used: the Yale-Brown Obsessive Compulsive Scale, the Dimensional Yale-Brown Obsessive Compulsive Scale, the Beck Depression and Anxiety Inventories, the Structured Clinical Interview for DSM-IV Axis I Disorders, and 6 specific questions to investigate suicidality. After univariate analyses, logistic regression analyses were performed to adjust the associations between the dependent and explanatory variables for possible confounders.
  
  
  RESULTS
  Thirty-six percent of the patients reported lifetime suicidal thoughts, 20% had made suicidal plans, 11% had already attempted suicide, and 10% presented current suicidal thoughts. In the logistic regression, only lifetime major depressive disorder and posttraumatic stress disorder (PTSD) remained independently associated with all aspects of suicidal behaviors. The sexual/religious dimension and comorbid substance use disorders remained associated with suicidal thoughts and plans, while impulse-control disorders were associated with current suicidal thoughts and with suicide plans and attempts.
  
  
  CONCLUSIONS
  The risk of suicidal behaviors must be carefully investigated in OCD patients, particularly those with symptoms of the sexual/religious dimension and comorbid major depressive disorder, PTSD, substance use disorders, and impulse-control disorders.
authors.affiliation: Departamento de Neurologia, Psicologia e Psiquiatria, Faculdade de Medicina de Botucatu, University Estadual Paulista (UNESP), Distrito de Rubião Jr, 18618-970, Botucatu, São Paulo, Brazil. torresar@fmb.unesp.br
authors.forename: Albina R
authors.initials: AR
authors.lastname: Torres
authors.forename: Ana Teresa A
authors.initials: AT
authors.lastname: Ramos-Cerqueira
authors.forename: Ygor A
authors.initials: YA
authors.lastname: Ferrão
authors.forename: Leonardo F
authors.initials: LF
authors.lastname: Fontenelle
authors.forename: Maria Conceição
authors.initials: MC
authors.lastname: do Rosário
authors.forename: Euripedes C
authors.initials: EC
authors.lastname: Miguel
mesh_terms: D000328:Adult; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D010555:Personality Inventory; D015995:Prevalence; D012069:Religion and Psychology; D012307:Risk Factors; D012725:Sexual Behavior / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data*; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires