scholarly journals Obsessive-Compulsive Disorder with Suicide Obsessions in a First Responder without Previous Diagnosis of OCD or History of Suicide Attempts

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Vivekananda Rachamallu ◽  
Michael M. Song ◽  
Haiying Liu ◽  
Charles L. Giles ◽  
Terry McMahon
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Suicide Attempts ◽  
Past History ◽  
Case Reports ◽  
First Responder ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Prevention Therapy ◽  
Increased Risk ◽  
History Of

Obsessive-compulsive disorder (OCD) is a distressing and often debilitating disorder characterized by obsessions, compulsions, or both that are time-consuming and cause impairment in social, occupational, or other areas of functioning. There are many published studies reporting higher risk of suicidality in OCD patients, as well as studies describing increased risk of suicidality in OCD patients with other comorbid psychiatric conditions such as major depressive disorder (MDD) and posttraumatic stress disorder (PTSD). Existing case reports on OCD with suicide as the obsessive component describe patients with long standing diagnosis of OCD with suicidal ideations or previous suicide attempts. This report describes the case of a 28-year-old male, who works as a first responder, who presented with new onset symptoms characteristic of MDD and PTSD, with no past history of OCD or suicidality who developed OCD with suicidal obsessions. Differentiating between suicidal ideation in the context of other psychiatric illnesses and suicidal obsessions in OCD is critical to ensuring accurate diagnosis and timely provision of most appropriate treatment. The combination of exposure and response prevention therapy and pharmacotherapy with sertraline and olanzapine was effective in helping the patient manage the anxiety and distress stemming from the patient’s OCD with suicidal obsession.

scholarly journals Does clozapine cause or worsen obsessive compulsive symptoms? An analysis and literature review

2011 ◽  
Vol 1 (6) ◽  
pp. 181-188 ◽  
Author(s):  
Stephen Bleakley ◽  
David Brown ◽  
David Taylor
Keyword(s):  
Obsessive Compulsive Disorder ◽  
De Novo ◽  
Case Reports ◽  
Obsessive Compulsive ◽  
Cross Sectional ◽  
Obsessive Compulsive Symptoms ◽  
Compulsive Disorder ◽  
Clozapine Treatment ◽  
Increased Risk ◽  
The Common

Background: Clozapine is the most effective antipsychotic in treatment-resistant schizophrenia but its use portends with a high burden of adverse reactions. One adverse event reported both in case reports and cross-sectional surveys is the emergence or worsening of obsessive compulsive symptoms (OCS). Objectives: This study presents a retrospective review of a UK cohort of clozapine-treated individuals with the aim to further investigate the complex relationship between clozapine and OCS. Methods: An extensive review of the medical records of 49 patients receiving clozapine in the Southampton area was undertaken. We searched for a diagnosis of obsessive compulsive disorder, signs or symptoms of obsessive compulsive disorder or the prescribing of selected antidepressants the year before clozapine initiation and the year after. Results: Fifteen patients (31%) had reports of OCS during the 2-year data collection period. Twelve patients (24%) had OCS before clozapine initiation while only 7 (14%) had symptoms after clozapine was initiated. De novo OCS were reported in three (6%) cases after 5–9 months of clozapine treatment. Conclusions: As with previous studies it was not possible to establish a definitive link between clozapine and OCS. Clinicians should be mindful of the common comorbidity of OCS and schizophrenia and the possible increased risk incurred when starting clozapine.

scholarly journals Suicidal Ideations in Patients With Obsessive-Compulsive Disorder

2022 ◽  
Vol 8 (1) ◽  
pp. 39-48
Author(s):  
Mohammadrasoul Khalkhali ◽  
◽  
Roghaye Zare ◽  
Hassan Farrahi ◽  
Peyvand Shambayati ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Obsessive Compulsive Disorder ◽  
Rating Scale ◽  
Suicide Attempts ◽  
Previous History ◽  
Obsessive Compulsive ◽  
Cross Sectional ◽  
Compulsive Disorder ◽  
First Degree Relatives ◽  
History Of

Background: There are many controversies about the frequency and burden of suicidality in patients with Obsessive-Compulsive Disorder (OCD). Objectives: This study was done to determine the prevalence and risk factors of current suicidal ideations in patients with OCD. Materials & Methods: In this cross-sectional study, 258 outpatients with OCD (Yale-Brawn Obsessive Compulsive Scale, Y-BOCS ≥16) referring to two psychiatry clinics in Guilan, Iran, from March 2018 to September 2019 were evaluated. Suicidality score of the Brief Psychiatric Rating Scale (BPRS) ≥4 was considered for current suicidal ideation at the first visit. Beck Scale for Suicidal Ideation (BSSI) was used to evaluate the intensity of suicidal ideations a week before evaluation. Simple linear and binary logistic regression analyses were used to analyze data by SPSS v. 20. Results: Current suicidal ideation was found in 22.1% of patients. The previous history of suicide attempt (BPRS, P<0.0001 and BSSI, P<0.0001), a history of OCD in first-degree relatives (BPRS: P=0.004 and BSSI: P=0.010), a history of suicide attempts in first-degree relatives (BPRS: P=0.013 and BSSI: P<0.0001), comorbid diagnosis of depressive or body dysmorphic disorder (BPRS, P<0.0001 and BSSI, P<0.0001), and higher Y-BOCS score (BPRS: P=0.043 and BSSI: P<0.0001) were associated with a higher risk of having suicidal ideation. Conclusion: Suicidal thoughts are high in Iranian patients with OCD at their first visit to psychiatry clinics. The previous suicide history, positive history of OCD and suicide attempts in their first-degree relatives, the severity of OCD, and some comorbid psychological disorders are associated with a higher risk of suicidal ideation among OCD patients.

Gender Differences in Obsessive Compulsive Disorder

1995 ◽  
Vol 29 (1) ◽  
pp. 114-117 ◽  
Author(s):  
David J. Castle ◽  
Alicia Deale ◽  
Isaac M. Marks
Keyword(s):  
Gender Differences ◽  
Eating Disorder ◽  
Anxiety Disorders ◽  
Obsessive Compulsive Disorder ◽  
Past History ◽  
Onset Age ◽  
Obsessive Compulsive ◽  
Behavioural Treatment ◽  
Compulsive Disorder ◽  
History Of

We investigated gender differences in 219 patients with obsessive compulsive disorder consecutively referred to a centre specialising in the behavioural treatment of anxiety disorders. Females had a later mean onset-age, and were more likely to be married and to have children; they were also marginally more likely to have a past history of an eating disorder or depression, while males were more likely to have a history of anxious or meticulous personality traits. Family loading for psychiatric disorders did not differ significantly between the sexes. The results are discussed in the context of the epidemiological literature on gender differences in OCD.

scholarly journals Increased Risk of Attempted and Completed Suicide in Obsessive Compulsive Disorder: A Systematic Review of Follow-up Studies

2018 ◽  
Vol 1 (2) ◽  
pp. 61-70
Author(s):  
Reinhard Heun
Keyword(s):  
High Risk ◽  
General Population ◽  
Obsessive Compulsive Disorder ◽  
Suicide Attempts ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Completed Suicide ◽  
Increased Risk

AbstractObsessive compulsive disorder (OCD) is a severe, often long-term mental disorder. It may be independent from, or comorbid with other mental disorders, especially depression and anxiety disorders. Suicidal thoughts, ideations and ruminations are prevalent in subjects with OCD, but it is not yet clear if the incidences of attempted and completed suicides have increased in comparison with the general population and with other psychiatric disorders.MethodsWe conducted a systematic literature search on the incidence of suicide attempts and completed suicides in subjects with OCD. Search terms for Pubmed and Medline were OCD and suicide. We selected papers providing follow-up data on the incidence of attempted and completed suicide in OCD.Results404 papers were initially identified. Only 8 papers covering six studies provided prospective data on attempted or completed suicide over a defined period in subjects with OCD, four studies included control subjects. Two studies providing follow-up data were limited to high-risk samples and did not provide enough data on the incidence of suicide in comparison with the general population. The conclusion that there is an increased risk of attempted and completed suicides in OCD can only be based on one large Swedish National Registry sample with an up to 44 year follow up. Psychiatric comorbidity is the most relevant risk factor for suicide.ConclusionsEven though some studies report an increased incidence of attempted and completed suicides in OCD patients from selected high risk samples, the evidence from population based studies is mostly based on one large Swedish study. More long-term studies in the general population with a reduced risk of subject attrition are needed. Using a clear definition and assessment of suicidal behaviour and a common time-frame would improve the comparability of future studies.

PROLACTIN IN CHILDHOOD OBSESSIVE-COMPULSIVE DISORDER: CLINICAL CORRELATES AND RESPONSE TO CLOMIPRAMINE

PEDIATRICS ◽  
1991 ◽  
Vol 88 (5) ◽  
pp. 992-992
Author(s):  
Gregory L. Hanna ◽  
James T. MCCracken ◽  
Dennis P. Cantwell
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Obsessive Compulsive ◽  
Tic Disorder ◽  
Obsessive Compulsive Symptoms ◽  
Compulsive Disorder ◽  
Serotonergic Receptors ◽  
Duration Of Illness ◽  
Chronic Tic Disorder ◽  
History Of ◽  
Clomipramine Treatment

Basal prolactin concentrations were measured before treatment in 18 children and adolescents with obsessive-compulsive disorder as well as in 15 of these patients after 4 and 8 weeks of clomipramine treatment. Basal prolactin levels were influenced by a history of chronic tic disorder and by the duration and severity of obsessive-compulsive symptoms. Clomipramine administration significantly increased basal prolactin levels. A slight decline in prolactin levels during the last 4 weeks of clomipramine treatment was positively correlated with a favorable treatment response and negatively correlated with duration of illness. If the changes in prolactin levels observed during clomipramine treatment are due primarily to changes in serotonergic neurotransmission, these data suggest that clomipramine treatment of obsessive-compulsive disorder produces an adaptive decrease in the responsiveness of serotonergic receptors.

Admixture analysis of age at onset in obsessive–compulsive disorder

2005 ◽  
Vol 35 (2) ◽  
pp. 237-243 ◽  
Author(s):  
RICHARD DELORME ◽  
JEAN-LOUIS GOLMARD ◽  
NADIA CHABANE ◽  
BRUNO MILLET ◽  
MARIE-ODILE KREBS ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Late Onset ◽  
Age At Onset ◽  
Admixture Analysis ◽  
Obsessive Compulsive ◽  
General Anxiety Disorder ◽  
General Anxiety ◽  
Compulsive Disorder ◽  
History Of ◽  
Best Fitting

Background. Age at onset (AAO) has been useful to explore the clinical, neurobiological and genetic heterogeneity of obsessive–compulsive disorder (OCD). However, none of the various thresholds of AAO used in previous studies have been validated, and it remains an unproven notion that AAO is a marker for different subtypes of OCD. If AAO is a clinical indicator of different biological subtypes, then subgroups based on distinct AAOs should have separate normal distributions as well as different clinical characteristics.Method. Admixture analysis was used to determine the best-fitting model for the observed AAO of 161 OCD patients.Results. The observed distribution of AAO in OCD is a mixture of two Gaussian distributions with mean ages of 11·1±4·1 and 23·5±11·1 years. The first distribution, defined by early-onset OCD, had increased frequency of Tourette's syndrome and increased family history of OCD. The second distribution, defined by late-onset OCD, showed elevated prevalence of general anxiety disorder and major depressive disorder.Conclusions. These results, based on a statistically validated AAO cut-off and those of previous studies on AAO in OCD, suggest that AAO is a crucial phenotypic characteristic in understanding the genetic basis of this disorder.

Suicidality and Aggressive Behavior in Body Dysmorphic Disorder

2017 ◽  
Author(s):  
Katharine A. Phillips
Keyword(s):  
Suicidal Ideation ◽  
Physical Aggression ◽  
Body Dysmorphic Disorder ◽  
Suicide Attempts ◽  
Violent Behavior ◽  
Clinical Samples ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Completed Suicide ◽  
Increased Risk

This chapter reviews suicidality and aggressive/violent behavior in body dysmorphic disorder (BDD) and presents clinical cases, which reflect the extreme suffering that BDD often causes. Suicidal ideation and suicide attempts are common in BDD. This has been found in both clinical and epidemiologic samples and in adults as well as youth. More severe BDD symptoms are independently associated with an increased risk of suicidal ideation and suicide attempts. Suicidality appears more common in BDD than in obsessive-compulsive disorder and other clinical samples with which BDD has been directly compared. Although data are limited, the rate of completed suicide appears markedly elevated; indeed, individuals with BDD have many risk factors for completed suicide. Physical aggression and violence are less well studied but appear to commonly occur as a consequence of BDD. Surgeons, dermatologists, and other clinicians who provide cosmetic treatment may be at particular risk. Additional studies designed to investigate these topics are urgently needed.

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