The suicidality continuum in a large sample of obsessive-compulsive disorder (OCD) patients.
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.



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.



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.



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.



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.
Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil; Obsessive-Compulsive Spectrum Disorder Research Consortium (C-TOC), Brazil. Electronic address: patvelloso@gmail.com.
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Velloso
Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil; Obsessive-Compulsive Spectrum Disorder Research Consortium (C-TOC), Brazil.
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Piccinato
Obsessive-Compulsive Spectrum Disorder Research Consortium (C-TOC), Brazil; Department of Psychiatry, Health Sciences Federal University of Porto Alegre, Porto Alegre, Brazil.
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Ferrão
Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil; Obsessive-Compulsive Spectrum Disorder Research Consortium (C-TOC), Brazil.
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Aliende Perin
Obsessive-Compulsive Spectrum Disorder Research Consortium (C-TOC), Brazil.
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Cesar
Obsessive-Compulsive Spectrum Disorder Research Consortium (C-TOC), Brazil; Department of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
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Fontenelle
Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil; Obsessive-Compulsive Spectrum Disorder Research Consortium (C-TOC), Brazil.
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Hounie
Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil; Obsessive-Compulsive Spectrum Disorder Research Consortium (C-TOC), Brazil.
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do Rosário
D000328:Adult; D001007:Anxiety / Q000523:psychology; 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 / Q000175:diagnosis / Q000523:psychology*; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology*; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology*; D013406:Suicide, Attempted / Q000523:psychology
OCD; Quality of life; Suicidality