Assessing suicide risk in patients with Obsessive-Compulsive Disorder: a dimensional approach

Objectives: Obsessive-Compulsive Disorder has recently been found to be associated with an increased risk of suicide; however, prevalence rates of both suicidal ideation and attempts vary considerably, being the phenomenon mainly categorically evaluated. Our aims were to evaluate the prevalence of suicidal ideation (SI) and behaviors (SB) using a dimensional approach. Methods: 129 patients with OCD were enrolled. Suicidality was assessed through the administration of the Columbia-Suicide Severity Rating Scale. Logistic and linear regressions were used to examine predictors of SI, severe SI, and SB. Results: Lifetime prevalence of SI and SB were 64.3% and 16.3%. Lifetime SI was associated with the number of stressful life events, the duration of illness, HAM-D scores, family history for mood disorders. A positive family history for OCD was associated with lower probability of lifetime SI. Severe SI was related to a greater severity of the highest stressful life event, HAM-D scores and a longer duration of untreated illness. The probability of lifetime SB was related to the HAM-A scores, symmetry obsessions, washing and checking compulsions. The probability of lifetime Non-Suicidal Self-Injurious Behaviors was related to HAM-A scores. Conclusions: The recognition of predictors of SI/SB is crucial to identify those patients at greater risk.