The suicidality continuum in a large sample of obsessive–compulsive disorder (OCD) patients

Velloso, Patricia; Piccinato, Cinthia; Ferrão, Ygor Arzeno; Perin, Eduardo Aliende; Cesar, R.; Fontenelle, Leonardo F.; Hounie, Ana Gabriela; Rosário, Maria Conceição do

doi:10.1016/j.eurpsy.2016.05.003

Cited by 53 publications

(58 citation statements)

References 49 publications

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“…Four main findings emerged. First, confirming previous studies conducted in clinical and community settings [1][2][3][4][5][43][44][45][46], individuals with OCD were at significantly increased risk of suicide attempts and death by suicide compared to individuals without OCD, and the risks were more pronounced for female than male OCD sufferers, similar to the results of another Swedish study on OCD and suicide [2]. This was anticipated in relation to suicide attempts, as nonfatal suicidal behavior is known to be more common in females [28,47].…”

Section: Discussionsupporting

confidence: 84%

Genetic and environmental sources of familial coaggregation of obsessive−compulsive disorder and suicidal behavior: a population-based birth cohort and family study

et al. 2019

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Obsessive−compulsive disorder (OCD) is associated with high risk of suicide. It is yet unknown whether OCD and suicidal behaviors coaggregate in families and, if so, what are the mechanisms underlying this coaggregation. In a population-based birth cohort and family study, we linked individuals born in Sweden in 1967-2003 (n = 3,594,181) to their parents, siblings, and cousins, and collected register-based diagnoses of OCD, suicide attempts, and deaths by suicide and followed them until December 31, 2013. We also applied quantitative genetic modeling to estimate the contribution of genetic and environmental factors to the familial coaggregation of OCD and suicidal behavior. An elevated risk of suicide attempts was observed across all relatives of individuals with OCD, increasing proportionally to the degree of genetic relatedness, with odds ratios (OR) ranging from 1.56 (95% confidence interval (CI) 1.49-1.63) in parents to 1.11 (95% CI 1.07-1.16) in cousins. The risk of death by suicide also increased alongside narrowing genetic distance, but was only significant in parents (OR 1.55; 95% CI 1.40-1.72) and full siblings (OR 1.80; 95% CI 1.43-2.26) of individuals with OCD. Familial coaggregation of OCD and suicide attempts was explained by additive genetic factors (60.7%) and non-shared environment (40.4%), with negligible contribution of shared environment. Similarly, familial coaggregation with death by suicide was attributed to additive genetics (65.8%) and nonshared environment (34.2%). Collectively, these observations indicate that OCD and suicidal behaviors coaggregate in families largely due to genetic factors. The contribution of unique environment is also considerable, providing opportunities to target high-risk groups for prevention and treatment.

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Section: Discussionsupporting

confidence: 84%

Genetic and environmental sources of familial coaggregation of obsessive−compulsive disorder and suicidal behavior: a population-based birth cohort and family study

et al. 2019

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“…Even though it did not remain significant in the regression analysis, the finding that suicide attempts rates among OCD + ADHD patients in this sample were almost two times higher compared with OCD adult subjects without ADHD is alarming. Previous studies have demonstrated that suicidality rates among OCD patients are high (Angelakis, Gooding, Tarrier & Panagioti, ; de la Cruz et al, ; Torres et al, ; Velloso et al, ) and that having suicide ideation almost doubled the risk for a suicide attempt (de la Cruz et al, ; Velloso et al, ). ADHD itself is also associated with higher mortality rates (Dalsgaard, Østergaard, Leckman, Mortensen & Pedersen, ).…”

Section: Discussionmentioning

confidence: 99%

The impact of attention deficit hyperactivity disorder in obsessive‐compulsive disorder subjects

et al. 2019

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Background: Recent findings suggest an association between attention deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD). Thus, we evaluated the clinical associated features of ADHD in a large sample of adult OCD patients. Methods:A cross-sectional study including 955 adult patients with OCD from the Brazilian Research Consortium of Obsessive-Compulsive Spectrum Disorders (C-TOC). Clinical characteristics in adult OCD patients with and without comorbid ADHD were compared using Fisher's exact test, t-tests or Mann-Whitney tests.Bivariate analyses were followed by logistic regression analysis to identify clinical characteristics independently associated with ADHD comorbidity. Results:The lifetime prevalence of ADHD in adult OCD patients was 13.7%. The current results indicate that OCD + ADHD patients were more severe, had an earlier onset of the obsessive-compulsive symptoms, a higher history of rheumatic fever, with higher frequencies of sensory phenomena and comorbidity with Tourette syndrome. They also had an increased risk for academic impairment and suicide attempts.Conclusion: Adult OCD patients with ADHD present some specific clinical features and may represent a special subgroup of adult OCD. Future studies should focus on the development of interventions more tailored to the phenotype of this subgroup of patients.

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“…BAI & BDI-II: Both BAI and BDI-II consist of 21 items, which are rated on a Likert scale ranging from 0 to 3, resulting in raw scores ranging from 0 to 63, and are indicative for the presence of anxiety or depression. The BAI is well suited to monitor anxiety treatment outcomes [49], and the obtained anxiety state is correlated with OCD symptoms [50,51]. Similarly, the BDI-II scores are associated with OCD symptoms [51] in line with the fact that around one-third of OCD patients suffer from comorbid depression [52].…”

Section: Y-bocsmentioning

confidence: 99%

“…The BAI is well suited to monitor anxiety treatment outcomes [49], and the obtained anxiety state is correlated with OCD symptoms [50,51]. Similarly, the BDI-II scores are associated with OCD symptoms [51] in line with the fact that around one-third of OCD patients suffer from comorbid depression [52]. Both measures have adequate psychometric properties [53,54].…”

Section: Y-bocsmentioning

confidence: 99%

Efficacy and clinical predictors of response to rTMS treatment in pharmacoresistant obsessive-compulsive disorder (OCD): A retrospective study

Rostami¹,

Kazemi

Jabbari³

et al. 2020

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Background: Application of repetitive transcranial magnetic stimulation (rTMS) for treating obsessive-compulsive disorder (OCD) has been promising and approved by the Food and Drug Administration in 2018, but effects differ between patients. Knowledge about clinical predictors of rTMS response may help to increase clinical efficacy but is not available so far. Methods: In a retrospective study, we investigated the efficacy of rTMS over the dorsolateral prefrontal cortex (DLPFC) or supplementary motor area (SMA) in 65 pharmaco-resistant OCD outpatients recruited for rTMS treatment from July 2015 to May 2017. Patients received either SMA rTMS (n = 38) or bilateral DLPFC rTMS (n = 27) in case of reporting higher affective and depressive symptoms in addition to the primary OCD symptoms. OCD symptoms and depression/anxiety states were measured at baseline (before the 1st session) and after the 20th session of rTMS. Additionally, we performed a binary logistic regression analysis on the demographic and clinical variables based on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) 3-factor and 2-factor models and individual items to investigate potential predictors of rTMS response. Results: Patients’ scores in Y-BOCS and Beck anxiety/depression inventories were significantly decreased following rTMS treatment. 46.2% of all patients responded to rTMS, based on the criterion of at least a 30% reduction in Y-BOCS scores. There was no significant difference between response rates of patients in DLPFC and SMA groups. No significant demographic predictors of rTMS efficacy were identified. The factors “Obsession severity”, “resistance” and “disturbance” and the “Interference due to obsessions” and “resistance against compulsions” items of the Y-BOCS significantly predicted response to rTMS. Conclusions: In patients with less intrusive/interfering thoughts, and low scores in the “obsession severity”, “disturbance”, and “resistance factors, rTMS might have superior effects. Identification of clinical and non-clinical predictors of response is relevant to personalize and adapt rTMS protocols in pharmaco-resistant OCD patients. Interpretation of rTMS efficacy should be done with caution due to the lack of a sham intervention condition.

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The suicidality continuum in a large sample of obsessive–compulsive disorder (OCD) patients

Cited by 53 publications

References 49 publications

Genetic and environmental sources of familial coaggregation of obsessive−compulsive disorder and suicidal behavior: a population-based birth cohort and family study

Genetic and environmental sources of familial coaggregation of obsessive−compulsive disorder and suicidal behavior: a population-based birth cohort and family study

The impact of attention deficit hyperactivity disorder in obsessive‐compulsive disorder subjects

Efficacy and clinical predictors of response to rTMS treatment in pharmacoresistant obsessive-compulsive disorder (OCD): A retrospective study

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