Treatment of Suicide Obsessions in Obsessive-Compulsive Disorder with Comorbid Major Depressive Disorder

Obsessive-Compulsive Disorder with Suicide Obsessions in a First Responder without Previous Diagnosis of OCD or History of Suicide Attempts

“…OCD with ego-dystonic suicidal obsessions have rarely been reported in the literature (see Table 1). Each previously reported case of OCD with suicidal obsessions has been in patients with history of long standing OCD, treatment refractory OCD, or history of suicide attempt (Table 1) [13–15]. The case report by Al-Zaben [13] describes a patient with suicidal obsession in long standing OCD with comorbid depression.…”

“…A case report by Wetzler et al [14] described a patient with long standing MDD who developed obsessive thoughts of harming herself following a failed suicide attempt (posttraumatic obsession). In addition, a case report by Watterneck et al [15] described suicidal obsession in a patient with chronic treatment-resistant OCD with comorbid depression who was successfully treated with methodology described by Foa et al [18], an evidence-based treatment for OCD. There is also a case report describing ego-dystonic suicidal obsessions occurring as a dose-dependent side-effect of clozapine [16].…”

“…Furthermore, violent obsessions have been reported to be positively correlated with suicidality in OCD [9, 12]. However, OCD with ego-dystonic suicidal obsessions have rarely been reported [13–15]. Al-Zaben described a patient with long history of both MDD and OCD who developed suicidal obsessions [13] while Wetzler et al described the development of OCD with suicidal obsessions in a patient with MDD, following a suicide attempt [14].…”

“…Al-Zaben described a patient with long history of both MDD and OCD who developed suicidal obsessions [13] while Wetzler et al described the development of OCD with suicidal obsessions in a patient with MDD, following a suicide attempt [14]. Furthermore, Wetterneck et al described OCD with suicidal obsession in a patient with treatment-resistant OCD [15] (see Table 1). This report describes the case of a 28-year-old male, who works as a first responder, who presented with symptoms characteristic of MDD and PTSD, with no past history of OCD or suicidality, with newly developed OCD with suicidal obsessions.…”

Suicidality in a 27-year-old Male with Obsessive Compulsive Disorder

“…These obsessions can build up leading to a catastrophic level of anxiety in patients and triggering suicidality in many of them [12]. In addition, a case study of treatment-resistant OCD patient has also shown an increase in suicide risk [13]. Thus the severity of OCD can then be a predictor of suicidality in patients.…”