title: Prevalence of suicide attempt and clinical characteristics of suicide attempters with obsessive-compulsive disorder: a report from the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS).
abstract: Obsessive-compulsive disorder (OCD) is associated with variable risk of suicide and prevalence of suicide attempt (SA). The present study aimed to assess the prevalence of SA and associated sociodemographic and clinical features in a large international sample of OCD patients.
  
  
  
  A total of 425 OCD outpatients, recruited through the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS) network, were assessed and categorized in groups with or without a history of SA, and their sociodemographic and clinical features compared through Pearson's chi-squared and t tests. Logistic regression was performed to assess the impact of the collected data on the SA variable.
  
  
  
  14.6% of our sample reported at least one SA during their lifetime. Patients with an SA had significantly higher rates of comorbid psychiatric disorders (60 vs. 17%, p<0.001; particularly tic disorder), medical disorders (51 vs. 15%, p<0.001), and previous hospitalizations (62 vs. 11%, p<0.001) than patients with no history of SA. With respect to geographical differences, European and South African patients showed significantly higher rates of SA history (40 and 39%, respectively) compared to North American and Middle-Eastern individuals (13 and 8%, respectively) (χ2=11.4, p<0.001). The logistic regression did not show any statistically significant predictor of SA among selected independent variables.
  
  
  
  Our international study found a history of SA prevalence of ~15% in OCD patients, with higher rates of psychiatric and medical comorbidities and previous hospitalizations in patients with a previous SA. Along with potential geographical influences, the presence of the abovementioned features should recommend additional caution in the assessment of suicide risk in OCD patients.
authors.affiliation: 1Department of Psychiatry,University of Milan,Fondazione IRCCS Ca'Granda,Ospedale Maggiore Policlinico,Milano,Italy.
authors.forename: Bernardo
authors.initials: B
authors.lastname: Dell'Osso
authors.affiliation: 1Department of Psychiatry,University of Milan,Fondazione IRCCS Ca'Granda,Ospedale Maggiore Policlinico,Milano,Italy.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Benatti
authors.affiliation: 1Department of Psychiatry,University of Milan,Fondazione IRCCS Ca'Granda,Ospedale Maggiore Policlinico,Milano,Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Arici
authors.affiliation: 1Department of Psychiatry,University of Milan,Fondazione IRCCS Ca'Granda,Ospedale Maggiore Policlinico,Milano,Italy.
authors.forename: Carlotta
authors.initials: C
authors.lastname: Palazzo
authors.affiliation: 1Department of Psychiatry,University of Milan,Fondazione IRCCS Ca'Granda,Ospedale Maggiore Policlinico,Milano,Italy.
authors.forename: A Carlo
authors.initials: AC
authors.lastname: Altamura
authors.affiliation: 3Department of Psychiatry and Behavioral Sciences,Albert Einstein College of Medicine and Montefiore Medical Center,New York,New York,USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Hollander
authors.affiliation: 4Mental Health Unit,Hertfordshire Partnership Foundation Trust,Queen Elizabeth II Hospital,Welwyn Garden City,United Kingdom.
authors.forename: Naomi
authors.initials: N
authors.lastname: Fineberg
authors.affiliation: 5MRC Unit on Anxiety and Stress Disorders,Department of Psychiatry and Mental Health,University of Cape Town,Cape Town,South Africa.
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
authors.affiliation: 6Genomics of Psychiatric and Neurodegenerative Diseases Laboratory, National Institute of Genomic Medicine (INMEGEN),Mexico City,Mexico.
authors.forename: Humberto
authors.initials: H
authors.lastname: Nicolini
authors.affiliation: 7Carracci Medical Group,Mexico City,Mexico.
authors.forename: Nuria
authors.initials: N
authors.lastname: Lanzagorta
authors.affiliation: 8Dipartimento di Psichiatria,Neurobiologia,Farmacologia e Biotechnologie,Università di Pisa,Italy.
authors.forename: Donatella
authors.initials: D
authors.lastname: Marazziti
authors.affiliation: 9Department of Psychiatry,University of Florence,and Institute of Neurosciences,Florence,Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Pallanti
authors.affiliation: 10Department of Psychiatry and Behavioural Neurosciences,McMaster University,Hamilton,Ontario,Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: van Ameringen
authors.affiliation: 11MRC Unit on Anxiety and Stress Disorders,Department of Psychiatry,University of Stellenbosch,South Africa.
authors.forename: Christine
authors.initials: C
authors.lastname: Lochner
authors.affiliation: 12Department of Psychiatry,Sisli Eftal Teaching and Research Hospital,Istanbul,Turkey.
authors.forename: Oguz
authors.initials: O
authors.lastname: Karamustafalioglu
authors.affiliation: 13University Multiprofile Hospital for Active Treatment in Neurology and Psychiatry Sveti Naum,Sofia,Bulgaria.
authors.forename: Luchezar
authors.initials: L
authors.lastname: Hranov
authors.affiliation: 14Department of Psychiatry,Academic Medical Center,University of Amsterdam,Amsterdam,The Netherlands.
authors.forename: Martijn
authors.initials: M
authors.lastname: Figee
authors.affiliation: 15National and Trustwide Services for OCD/BDD,SW London and St. George's,National Health Service Trust,London,United Kingdom.
authors.forename: Lynne
authors.initials: L
authors.lastname: Drummond
authors.affiliation: 2Department of Psychiatry and Behavioral Sciences,Stanford University,Stanford,California,USA.
authors.forename: Carolyn I
authors.initials: CI
authors.lastname: Rodriguez
authors.affiliation: 16Department of Psychiatry and Behavioral Neuroscience,University of Chicago,Illinois,USA.
authors.forename: John
authors.initials: J
authors.lastname: Grant
authors.affiliation: 14Department of Psychiatry,Academic Medical Center,University of Amsterdam,Amsterdam,The Netherlands.
authors.forename: Damiaan
authors.initials: D
authors.lastname: Denys
authors.affiliation: 17Psychiatry Unit at the Hospital Universitari de Bellvitge-IDIBELL,University of Barcelona, Cibersam,Barcelona,Spain.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Menchon
authors.affiliation: 18Tel Aviv University, Sackler School of Medicine, Israel Post-Trauma Center, Research Foundation by the Sheba Medical Center,Israel.
authors.forename: Joseph
authors.initials: J
authors.lastname: Zohar
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000453:epidemiology* / Q000473:pathology / Q000523:psychology; D015995:Prevalence; D013406:Suicide, Attempted / Q000706:statistics & numerical data*
keywords: Obsessive-compulsive disorder; comorbidity; hospitalization; prevalence; suicide attempt