title: Alexithymia, responsibility attitudes and suicide ideation among outpatients with obsessive-compulsive disorder: an exploratory study.
abstract: OBJECTIVE
  Obsessive-compulsive disorder (OCD) is psychiatric disorder with a significant suicide risk, and the presence of alexithymia may increase this risk. As several studies attribute an important role, in OCD, to responsibility, the aims of this study were to evaluate possible clinical differences between patients positive or not for alexithymia concerning disorder severity, responsibility attitudes and suicide ideation and investigate which variables were associated with increased suicide ideation.
  
  
  METHODS
  104 adult outpatients with OCD were recruited. Alexithymia was measured with Toronto Alexithymia Scale (TAS-20), attitude about responsibility was tested with Responsibility Attitude Scale (RAS), suicide ideation was assessed with Scale of Suicide Ideation (SSI) and depressive symptoms were evaluated with Montgomery Åsberg Depression Rating Scale (MADRS). Score of item #11 on the Y-BOCS was considered as a measure of insight.
  
  
  RESULTS
  Patients positive for alexithymia showed higher responsibility attitudes and more severe suicide ideation. In a blockwise regression model, the presence of lower insight, higher RAS scores and difficulty in identifying feelings dimension of TAS-20 were associated with higher SSI scores.
  
  
  CONCLUSIONS
  OCD patients with alexithymia may show higher disorder severity, lower insight and inflated responsibility, all related to suicide ideation, independently from depressive symptoms. Implications were discussed and study limitations considered and reported.
authors.affiliation: NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy; Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio" of Chieti, Chieti Scalo, Italy. Electronic address: dodebera@aliceposta.it.
authors.forename: Domenico
authors.initials: D
authors.lastname: De Berardis
authors.affiliation: NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Serroni
authors.affiliation: NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Campanella
authors.affiliation: NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Rapini
authors.affiliation: NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Olivieri
authors.affiliation: NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Feliziani
authors.affiliation: Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio" of Chieti, Chieti Scalo, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Carano
authors.affiliation: Hermanas Hospitalarias, FoRiPsi, Villa S. Giuseppe Hospital, Ascoli Piceno, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Valchera
authors.affiliation: Laboratory of Molecular Psychiatry and Psychopharmacotherapeutics, Section of Psychiatry, Department of Neuroscience, University School of Medicine "Federico II", Naples, Italy.
authors.forename: Felice
authors.initials: F
authors.lastname: Iasevoli
authors.affiliation: Laboratory of Molecular Psychiatry and Psychopharmacotherapeutics, Section of Psychiatry, Department of Neuroscience, University School of Medicine "Federico II", Naples, Italy.
authors.forename: Carmine
authors.initials: C
authors.lastname: Tomasetti
authors.affiliation: Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Mazza
authors.affiliation: Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Fornaro
authors.affiliation: Department of Psychiatry and Neuropsychology, University of Maastricht, Maastricht, The Netherlands; Hermanas Hospitalarias, FoRiPsi, Department of Clinical Neurosciences, Villa San Benedetto Menni, Albese con Cassano, Como, Italy; Department of Psychiatry and Behavioral Sciences, Leonard Miller School of Medicine, University of Miami, FL, USA.
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Perna
authors.affiliation: Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Di Nicola
authors.affiliation: Hermanas Hospitalarias, FoRiPsi, Villa S. Giuseppe Hospital, Ascoli Piceno, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Martinotti
authors.affiliation: Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio" of Chieti, Chieti Scalo, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Di Giannantonio
mesh_terms: D000293:Adolescent; D000328:Adult; D000342:Affective Symptoms / Q000523:psychology*; D001290:Attitude; D003863:Depression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009771:Obsessive-Compulsive Disorder / Q000523:psychology*; D010045:Outpatients / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D012306:Risk; D059020:Suicidal Ideation; D055815:Young Adult