Is OCD at risk for suicide? A case-control study

Object: Literature about suicidality in OCD is conflicting. In some studies OCD is associated to low suicide risk while others report increased frequency for suicidal ideation and behaviours. This discrepancy has been explained by the presence of comorbid depression in high-risk studies. Notwithstanding, comorbid OCD was associated to independent increase in suicide risk in patients with mood disorders or schizophrenia, therefore the relation between OCD and suicidality is still unclear. We hypothesize that OCD carries a low risk for suicide, that suicide ideation and lifetime attempts in OCD are due to comorbid MDE, and that MDE patients carry the same suicidal risk of OCD/MDE patients. Method: We compared 58 OCD patients with 58 OCD patients with major depression (OCD/MDE) and 58 with MDE. Patients were administered the SCID-I, the HDRS (OCD/MDE and MDE patients) and the Y-BOCS (OCD and OCD/ MDE patients). Current suicidal ideation was assessed by HDRS Item 3, lifetime suicide attempts by direct interview and by searching clinical charts. Results: MDE and OCD/MDE patients displayed higher rates of suicidal ideation than OCD patients (48.3% vs. 50% vs. 13.8% p<0.001). Lifetime suicide attempts were slightly more frequent in MDE than in OCD/MDE and OCD groups, although the difference was not significant. Conclusions: OCD patients display minimal suicidal ideation, while both MDE groups have higher suicidal ideation. The equality of suicidal ideation in OCD/MDE and MDE groups demonstrate that OCD doesn't increase suicidality in depressed patients. © 2007 Giovanni Fioriti Editore s.r.l.