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This is a Case-Control Study study.

September 16, 2025Open Access

Dissecting the phenomenon of suicidality in patients with obsessive-compulsive disorder: A descriptive psychopathological study

YFYgor Arzeno FerrãoDalhousie University JFJoão Vítor Bueno FerrãoHospital São Lucas da PUCRS JSJA SilvaUniversidade de Fortaleza

Puntos clave

Patients with OCD showed markedly higher suicidality scores on 13 DETECT-S items compared to controls, indicating serious concerns.
Suicidal ideation lifetime prevalence was significantly more in OCD patients, alongside various concerning suicidal thoughts and plans.
Case-control methodology involving 114 OCD patients and 127 controls assessed suicidality through the DETECT-S inventory and correlational metrics.
Findings may guide targeted therapeutic interventions for suicidality in OCD, highlighting an urgent need to address mental health challenges.

Resumen

Introduction There are conflicting and inconclusive results regarding suicidality in patients with obsessive-compulsive disorder (OCD). Objectives To describe the different psychopathological aspects of suicidality (suicidal ideation, suicide attempts, completed suicide, family history, etc.) in OCD. Methods In this case-control study we compared 114 patients with OCD and 127 controls (no OCD general hospital inpatients). The psychopathological aspects of suicidality were obtained through a 24 questions specific suicidality inventory (DETEC-S). Other instruments/data (Beck Depression and Anxiety Inventories, family history of psychiatric disorders, symptom severity scale, and psychiatric comorbidities) will be described in another study. Results Patients with OCD reported: less will to live (p=0.005); greater will to die (p<0.001); more reasons to die (p=0.022); greater lifetime history of suicidal ideation (SI) (p<0.001); accept the idea of dying (p<0.001); admit death as an escape from problems (p<0.001); suicidal plan in the past (p=0.019); admit courage and ability to commit suicide (p=0.003); no organization for the afterlife (p=0.021); have already talked to other people about SI (p<0.001); access to a lethal method (p=0.047); higher rates of family members, close people or friends who have already attempted suicide (p=0.008). They did not differ from the controls: would save themselves in case of an accident; current intention to commit suicide; able to control suicidal desire; would not commit suicide because of family, friends or religion; absence of current suicidal plan; suicidal desire or plan in the near future; writing a suicide note; prevalence of lifetime suicide attemp (SA); when they had SA, there was no need for medical care; and suicide success rates of family members, close people or friends. There was no significant difference in the total DETECT-S score (p=0.086). There was a moderate and direct correlation of suicidality scores with: the current severity of OCD and (r=0.32; p=0.001), especially at the expense of the severity of compulsions (r=0.35; p<0.001); and with the severity of depressive symptoms (r=0.43; p<0.001); average rate of lifetime improvement of symptoms (r=0.36; p=0.007). We found a moderate and indirect correlation with total quality of life scores (r=-0.47; p<0.001), especially at the expense of aspects related to the physical (r=-0.47), psychological (-0.47) and environmental (r=-0.42) domains (all with p<0.001). Conclusions Suicidality appears to be markedly present in patients with OCD (of the 24 psychopathological aspects of the DETECT-S questionnaire, patients had higher scores in 13 items) even when compared to patients admitted to a general hospital. A detailed approach to suicidality in patients with OCD may help in therapeutic planning and reduce patient suffering. Disclosure of Interest None Declared

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