Comorbidity, age of onset and suicidality in obsessive–compulsive disorder (OCD): An international collaboration

Brakoulias, Vlasios; Starčević, Vladan; Belloch, Amparo; Brown, Chris; Ferrão, Ygor Arzeno; Fontenelle, Leonardo F.; Löchner, Christine; Marazziti, Donatella; Matsunaga, Hisato; Miguel, Eurí­pedes Constantino; Reddy, Y.C. Janardhan; Rosario, Maria Conceição do; Shavitt, Roseli Gedanke; Sundar, A Shyam; Stein, Dan J.; Torres, Albina Rodrigues; Viswasam, Kirupamani

doi:10.1016/j.comppsych.2017.04.002

Cited by 160 publications

(129 citation statements)

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“…The observed increase of attempted and completed suicide in prospective studies, especially the one from Fernandez et al 2017, is comparable to the reports from previous crosssectional and retrospective studies: Data from 3711 adult patients with primary OCD that came from several countries indicated that suicidal ideation within the last month was reported by 6.4% (n = 200) of patients with OCD and a lifetime history of suicide attempt was observed in 9.0% (n = 314) (Brakoulias et al 2017). In agreement, patients with a previous suicide attempt had significantly higher rates of comorbid psychiatric disorders (Dell'Osso et al 2017).…”

Section: Outcome Of Literature Searchsupporting

confidence: 82%

“…In a recent large multinational study, suicidal ideation within the last month was reported by 6.4% (n = 200) of patients with OCD, a lifetime history of previous suicide attempts was observed in 9.0% (n = 314) (Brakoulias et al 2017). Crosssectional studies reveal that OCD is not only associated with a high risk of depression but also of recent suicidal behaviour (Chaudhary et al 2016).…”

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confidence: 99%

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

Heun

2018

Global Psychiatry

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Obsessive 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.

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Section: Outcome Of Literature Searchsupporting

confidence: 82%

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confidence: 99%

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

Heun

2018

Global Psychiatry

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“…As such, these dimensions provide a useful framework in which emotion-involvement in OCD symptoms can be studied [39]. Finally, given the overlap at the conceptual, etiological, and phenomenological level between OCD and the anxiety disorders [40,41], studies examining potential emotion-related motivators in individuals with OCD should include anxiety disordered comparison groups to help distinguish between potentially OCD-specific, anxiety-specific, and transdiagnostic emotional processes.…”

Section: Introductionmentioning

confidence: 99%

Involvement of fear, incompleteness, and disgust during symptoms of pediatric obsessive–compulsive disorder

Cervin

Perrin

Olsson³

et al. 2020

Eur Child Adolesc Psychiatry

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Fear has been assigned a central role in models of obsessive-compulsive disorder (OCD), but empirical investigations into the emotions that underpin OCD symptoms are few, especially in pediatric samples. Using validated, clinician-led structured interviews, 124 youth with OCD reported on the presence and severity of symptoms across the main symptom dimensions of OCD (aggressive, symmetry, contamination) and the degree to which fear, incompleteness, and disgust accompanied these symptoms. For comparison purposes, the degree of fear, incompleteness, and disgust during symptoms was obtained also from youth with social anxiety disorder (SAD; n = 27) and generalized anxiety disorder (GAD; n = 28). Participants with OCD reported that all three emotions were involved in their symptoms; however, fear was most strongly linked to aggressive symptoms, incompleteness to symmetry symptoms, and disgust to contamination symptoms. Incompleteness differentiated youth with OCD from those with SAD and GAD. No differences for these emotions were found for youth with OCD with versus without the tic-disorder subtype or comorbid autism. A positive association between incompleteness and self-reported hoarding emerged among youth with OCD. Further studies of the emotional architecture of pediatric OCD, and its relationship to etiology and treatment, are warranted.

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“…While obsessive-compulsive symptoms lie on a continuum (Abramowitz et al 2014), OCD affects 2-3% of the population (e.g. Ruscio et al 2010) and has a high comorbidity with depression and anxiety disorders (Brakoulias et al 2017;Macy et al 2013;Ruscio et al 2010).…”

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confidence: 99%

The Association of Trait Mindfulness and Self-compassion with Obsessive-Compulsive Disorder Symptoms: Results from a Large Survey with Treatment-Seeking Adults

2019

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Little is known about the role of mindfulness and self-compassion in obsessive-compulsive disorder. This cross-sectional study examined associations of mindfulness and self-compassion with obsessive-compulsive disorder symptoms and with the obsessive beliefs and low distress tolerance thought to maintain them. Samples of treatment-seeking adults (N = 1871) and non-treatment-seeking adults (N = 540) completed mindfulness, self-compassion, obsessive-compulsive disorder, anxiety, depression, obsessive beliefs and distress tolerance questionnaires. Participants with clinically significant obsessivecompulsive disorder symptoms reported lower trait mindfulness and self-compassion compared to participants with clinically significant anxiety/depression and to non-clinical controls. Among the clinical sample, there were medium-large associations between mindfulness and self-compassion and obsessive-compulsive disorder symptoms, obsessive beliefs and distress tolerance. Mindfulness and self-compassion were unique predictors of obsessive-compulsive disorder symptoms, controlling for depression severity. Once effects of obsessive beliefs and distress tolerance were controlled, a small effect remained for mindfulness (facets) on obsessing symptoms and for self-compassion on washing and checking symptoms. Directions for future research and clinical implications are considered in conclusion. Keywords Obsessive-compulsive disorder • Mindfulness • Self-compassion • Obsessive beliefs • Distress tolerance Obsessive-compulsive disorder (OCD) is a debilitating mental health condition characterised by obsessions, i.e. persistent unwanted intrusive thoughts, images or urges that can cause significant distress, and compulsions, i.e. repetitive, ritualistic behaviours aimed at alleviating distress and/ or preventing negative outcomes (APA 2013). Obsessivecompulsive disorder is a heterogeneous disorder as obsessions can centre on contamination, harm, symmetry or taboo thoughts and compulsions include physical behaviours like Electronic supplementary material The online version of this article (

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Comorbidity, age of onset and suicidality in obsessive–compulsive disorder (OCD): An international collaboration

Cited by 160 publications

References 22 publications

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

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

Involvement of fear, incompleteness, and disgust during symptoms of pediatric obsessive–compulsive disorder

The Association of Trait Mindfulness and Self-compassion with Obsessive-Compulsive Disorder Symptoms: Results from a Large Survey with Treatment-Seeking Adults

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