scholarly journals Suicide Risk in Obsessive-Compulsive Disorder and Exploration of Risk Factors: A Systematic Review

2019 ◽  
Vol 17 (8) ◽  
pp. 681-696 ◽  
Author(s):  
Umberto Albert ◽  
Diana De Ronchi ◽  
Giuseppe Maina ◽  
Maurizio Pompili

Background: Historically, OCD has been considered to be associated with a relatively low risk of suicide. Recent studies, on the contrary, revealed a significant association between OCD and suicide attempts and ideation. A huge variation in prevalence rates, however, is reported. Objective: To estimate prevalence rates of suicide attempts and suicidal ideation in individuals with OCD, and to identify predictors of suicide risk among subjects with OCD. Methods: We systematically reviewed the literature on suicide risk (ideation and/or attempts) and OCD. We included studies with appropriate definition of OCD, cross-sectional or prospective design, separating clinical samples from epidemiological studies, that employed a quantitative measure of suicidality and/or reported an outcome measure of the association between suicidality and OCD or examined factors associated with suicidality. Results: In clinical samples, the mean rate of lifetime suicide attempts is 14.2% (31 studies: range 6- 51.7%). Suicidal ideation is referred by 26.3-73.5% of individuals (17 studies, mean 44.1%); current suicidal ideation rate ranges between 6.4 and 75% (13 studies, mean 25.9). Epidemiological studies found that OCD increases significantly the odds of having a lifetime suicidal ideation as compared to the general population (OR: 1.9-10.3) and a history of lifetime suicide attempts (OR: 1.6- 9.9). Predictors of greater suicide risk are severity of OCD, the symptom dimension of unacceptable thoughts, comorbid Axis I disorders, severity of comorbid depressive and anxiety symptoms, past history of suicidality and some emotion-cognitive factors such as alexithymia and hopelessness. Conclusion: Overall, suicidality appears a relevant phenomenon in OCD.

2009 ◽  
Vol 31 (3) ◽  
pp. 271-280 ◽  
Author(s):  
Lena Nabuco de Abreu ◽  
Beny Lafer ◽  
Enrique Baca-Garcia ◽  
Maria A. Oquendo

OBJECTIVE: This article reviews the evidence for the major risk factors associated with suicidal behavior in bipolar disorder. METHOD: Review of the literature studies on bipolar disorder, suicidal behavior and suicidal ideation. RESULTS: Bipolar disorder is strongly associated with suicide ideation and suicide attempts. In clinical samples between 14-59% of the patients have suicide ideation and 25-56% present at least one suicide attempt during lifetime. Approximately 15% to 19% of patients with bipolar disorder die from suicide. The causes of suicidal behavior are multiple and complex. Some strong predictors of suicidal behavior have emerged in the literature such as current mood state, severity of depression, anxiety, aggressiveness, hostility, hopelessness, comorbidity with others Axis I and Axis II disorders, lifetime history of mixed states, and history of physical or sexual abuse. CONCLUSION: Bipolar disorder is the psychiatric condition associated with highest lifetime risk for suicide attempts and suicide completion. Thus it is important to clinicians to understand the major risk factors for suicidal behavior in order to choose better strategies to deal with this complex behavior.


Author(s):  
Katharine A. Phillips

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.


2019 ◽  
pp. 1-19
Author(s):  
Jessica L. Tylicki ◽  
Martin Sellbom ◽  
Yossef S. Ben-Porath

Prior research has shown that psychopathic personality traits are differentially related to suicide risk, and limited literature also suggests the potential that such risk manifests differently across sex. The current study sought to examine whether sex moderated associations between domains from the triarchic model of psychopathy, a comprehensive perspective of psychopathy, and various suicide variables. Our sample included 1,064 criminal defendants (760 males, 304 females), who had been administered the MMPI-2-RF, from which triarchic psychopathy scales were scored. Suicide-related variables, including current suicidal ideation during interview, history of previous suicide attempts, and number of previous suicide attempts, were reliably obtained from clinical records. The MMPI-2-RF SUI (Suicide/Death Ideation) scale was also examined as a psychometric operationalization of suicidality. Results provided evidence for the general association between psychopathy-related traits and suicide-related outcomes in a manner consistent with the literature. However, these associations did not differ as a function of sex.


Author(s):  
Brian Rothberg ◽  
Robert E. Feinstein

All psychiatric assessments should include screening for recent suicidal ideation and past suicide behavior. The Columbia-Suicide Severity Rating Scale (C-SSRS) provides a reliable objective assessment of suicide risk. A history of past suicide attempts is a risk factor for future suicide, and risk is increased by more serious, more frequent, or more recent attempts. Over 90% of individuals who die by suicide have at least one psychiatric disorder. Patients with schizophrenia, alcohol and other substance use disorders, and borderline and antisocial personality disorders are at increased risk for suicide. Familial transmission of suicide risk appears to occur independent of the familial risk for psychiatric disorders; impulsivity seems to be an inherited trait that makes individuals more vulnerable to suicide. Hospitalization should be considered if suicidal ideation is present in a patient who is psychotic or who has a history of past attempts, particularly if near lethal, and may be the safest option in patients with other contributing medical conditions, limited family or social support, or lack of access to timely outpatient follow-up.


2022 ◽  
Vol 8 (1) ◽  
pp. 39-48
Author(s):  
Mohammadrasoul Khalkhali ◽  
◽  
Roghaye Zare ◽  
Hassan Farrahi ◽  
Peyvand Shambayati ◽  
...  

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.


Author(s):  
Joana Straub ◽  
Ferdinand Keller ◽  
Nina Sproeber ◽  
Michael G. Koelch ◽  
Paul L. Plener

Objective: Research in adults has identified an association between bipolar disorder and suicidal behavior. This relationship, however, has been insufficiently investigated in adolescents to date. Methods: 1,117 adolescents from 13 German schools (mean age = 14.83, SD = .63; 52.7% females) completed an extended German version of the Center for Epidemiological Studies Depression Scale (CES-D), which assesses depressive and manic symptoms during the last week, as well as the Self-Harm Behavior Questionnaire (SHBQ) for the assessment of lifetime suicidal behavior. Results: In the present sample 39.4% of the girls and 23.1% of the boys reported lifetime suicidal thoughts and 7.1% of the girls as well as 3.9% of the boys a lifetime history of suicide attempts. 18.7% of the adolescent sample revealed elevated symptoms of depression and 9% elevated levels of mania symptoms. Elevated sum scores of depression and mania were associated with a higher number of suicidal ideations and suicide attempts. A block-wise regression analysis revealed that sum scores of depression and mania predicted suicidal ideations best. Concerning suicide attempts, the best predictors were age as well as depression and mania sum scores. Conclusions: Suicidal behavior was reported more often when adolescents demonstrate symptoms of mania as well as symptoms of depression than when they demonstrate only depressive symptoms. The presence of bipolar symptoms in adolescents should alert clinicians to the heightened possibility of suicidal behavior.


Crisis ◽  
2015 ◽  
Vol 36 (4) ◽  
pp. 267-273 ◽  
Author(s):  
Hajime Sueki ◽  
Jiro Ito

Abstract. Background: Nurturing gatekeepers is an effective suicide prevention strategy. Internet-based methods to screen those at high risk of suicide have been developed in recent years but have not been used for online gatekeeping. Aims: A preliminary study was conducted to examine the feasibility and effects of online gatekeeping. Method: Advertisements to promote e-mail psychological consultation service use among Internet users were placed on web pages identified by searches using suicide-related keywords. We replied to all emails received between July and December 2013 and analyzed their contents. Results: A total of 139 consultation service users were analyzed. The mean age was 23.8 years (SD = 9.7), and female users accounted for 80% of the sample. Suicidal ideation was present in 74.1%, and 12.2% had a history of suicide attempts. After consultation, positive changes in mood were observed in 10.8%, 16.5% showed intentions to seek help from new supporters, and 10.1% of all 139 users actually took help-seeking actions. Conclusion: Online gatekeeping to prevent suicide by placing advertisements on web search pages to promote consultation service use among Internet users with suicidal ideation may be feasible.


Crisis ◽  
2011 ◽  
Vol 32 (5) ◽  
pp. 283-287 ◽  
Author(s):  
L. F. Chan ◽  
T. Maniam ◽  
A. S. Shamsul

Background: Depressed inpatients constitute a high-risk population for suicide attempts. Aims: To describe the interactions of clinical and psychosocial risk factors influencing suicide attempts among a Malaysian sample of depressed inpatients. Methods: Seventy-five subjects were diagnosed with a depressive disorder according to the Structured Clinical Interview for DSM-IV Axis I Disorders-Clinical Version (SCID-CV). Data on suicide attempts, suicidal ideation (Scale for Suicidal Ideation, SSI), depression severity (Beck’s Depression Inventory, BDI), recent life-event changes (Social Readjustment Rating Scale, SRRS), sociodemographic and other relevant clinical factors were collected. Results: A third of the subjects presented after a current suicide attempt. Significant factors for a current suicide attempt were race, religion, recent life-event changes, suicidal ideation, and alcohol use disorder. Independent predictive risk factors for a current suicide attempt were Chinese race, recent marital separation, major mortgage or loans, and being newly diagnosed with depression. Any recent change in personal habits was shown to be a protective factor against current suicide attempt. Age and gender were nonsignificant factors. Conclusions: The findings are generally consistent with existing studies and highlight the role of psychosocial risk factors.


2017 ◽  
Vol 41 (S1) ◽  
pp. S101-S101
Author(s):  
D. Cozman ◽  
R. Moldovan ◽  
B. Nemes

IntroductionA better understanding of the genomics of mental illnesses allowed genetic counselling to be provided to individuals with severe mental illness and their families.AimThe present study was aimed at assessing the efficacy of genetic counselling for severe mental illnesses with high suicide risk.MethodAssessment was performed before and after genetic counselling session. Measures used were evaluation of traumatic events in childhood, multidimensional scale for perception of social support (SMSSP), positive and negative affect schedule (PANAS-X), Brief Psychiatric Rating Scale (BPRS), Paykel questionnaire and Genetic Counselling Outcome Scale (GCOS). Paykel's questionnaire consists of five questions about suicidal thoughts and attempts, including: life-weariness, death wishes, suicidal ideation, suicidal plans and suicide attempts. Intervention and assessment lasted approximately one and a half hour. Data from 48 patients was analysed.ResultsMean age of participants was M = 38.4, SD = 9.7, and the group was batter represented by females (57%). The participants had various diagnoses, 22% had schizophrenia, 36% bipolar disorder and 42% recurrent depressive disorder. Forty percent of participants reported suicidal ideation and 22,5% had a past history of suicide attempt. Genetic counselling had a direct positive influence upon GCOS specific items and reduced the Paykel scores among participants presenting with suicidal ideation.ConclusionGenetic counselling offers information about the disorder, the role of genetics and the impact of environmental factors. Preliminary data suggest that providing genetic counselling decreases the suicidal ideation frequency.Disclosure of interestThe authors have not supplied their declaration of competing interest.


1998 ◽  
Vol 173 (6) ◽  
pp. 531-535 ◽  
Author(s):  
Erkki T. Isometsä ◽  
Jouko K. Lönnqvist

BackgroundThis study investigated three questions with major implications for suicide prevention: the sensitivity of the history of previous suicide attempt(s) as an indicator of suicide risk, the time interval from a preceding suicide attempt to the fatal one, and switching of suicide methods by those eventually completing suicide.MethodThe lifetime history of suicide attempts and the methods the victims (n=1397) used were examined in a nationwide psychological autopsy study comprising all suicides in Finland within a 12-month research period in 1987–1988.ResultsOverall, 56% of suicide victims were found to have died at their first suicide attempt, more males (62%) than females (38%). In 19% of males and 39% of females the victim had made a non-fatal attempt during the final year. Of the victims with previous attempts, 82% had used at least two different methods in their suicide attempts (the fatal included).ConclusionsMost male and a substantial proportion of female suicides die in their first suicide attempt, a fact that necessitates early recognition of suicide risk, particularly among males. Recognition of periods of high suicide risk on the grounds of recent non-fatal suicide attempts is likely to be important for suicide prevention among females. Subjects completing suicide commonly switch from one suicide method to another, a finding that weakens but does not negate the credibility of restrictions on the availability of lethal methods as a preventive measure.


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