Alexithymia, suicidal ideation, and serum lipid levels among drug-naïve outpatients with obsessive-compulsive disorder

Abstract

Objective: As obsessive-compulsive disorder (OCD) is a relatively common psychiatric disorder with a significant suicide risk, the individuation of potential biomarkers of suicidality, such as cholesterol levels, may enable recognition of at-risk subjects. Therefore, the aims of this study were to: 1) evaluate potential differences in clinical and laboratory parameters between patients with and without alexithymia and compare them with healthy controls; and 2) investigate which clinical and laboratory variables were associated with suicidal ideation. Methods: 79 drug-naïve adult outpatients with a DSM-IV diagnosis of OCD were recruited. Alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20), suicidal ideation was assessed with the Scale for Suicide Ideation, and depressive symptoms were evaluated with the Montgomery-Å sberg Depression Rating Scale (MADRS). Serum lipid levels of 40 healthy controls were also evaluated. Results: Alexithymic patients had altered serum lipid levels in comparison with non-alexithymics and healthy controls. Using a linear regression model, the presence of symmetry/ordering obsessions and compulsions, lower HDL-C levels, and difficulty in identifying feelings dimension of the TAS-20 were associated with higher suicidal ideation. Conclusions: Alexithymic individuals with OCD may exhibit dysregulation of the cholesterol balance, which in turn may be linked to suicidal ideation. Further prospective studies are required to elucidate this potential association.

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)

“…A suicidal act may therefore be a way of expressing intolerable psychological pain 18 . Finally, a link between serum lipid levels and suicidal ideation has been hypothesized, since some studies 19 , 20 have reported that serum lipid levels might be involved in the pathogenesis of such neuropsychiatric disorders as OCD, and that these parameters have been potentially identified as biomarkers of suicidality.…”

Two systems for empathy in obsessive-compulsive disorder: mentalizing and experience sharing

“…1,2 A growing body of research has implicated emotion recognition proneness in the etiology and maintenance of OCD. [3][4][5] However, results from these studies are inconsistent with the findings of other studies, [6][7][8] which showed that patients with OCD were not impaired in the perception of emotion.…”

Association between the Catechol-O-Methyltransferase (COMT) Val158Met Polymorphism and Alexithymia in Patients with Obsessive-Compulsive Disorder

“… 5 In a recent study, OCD patients with higher alexithymic traits were also found to have a dysregulated cholesterol imbalance, which in turn may be associated with suicidal regulation. 6 …”