What is the role of obsessive-compulsive disorder (OCD) in the development of suicidal behaviors?

Updated: Jul 26, 2021
  • Author: Stephen Soreff, MD; Chief Editor: Glen L Xiong, MD  more...
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Obsessive-compulsive disorder (OCD) and phobic disorders have symptoms that make suicide a possibility. Persons struggling with these symptoms feel frightened, terrorized, isolated, and physically paralyzed by feelings of anxiety, panic, and dread that often seem inexplicable. In many instances, people feel that the symptoms are growing, expanding, and becoming incapacitating.

Obsessive-compulsive symptoms (OCS) in college students have been linked to suicidality. Researchers studied a cohort of 474 college students who attended mental health screenings at two private universities and completed multiple self-report questionnaires. Data show the presence of one or more OCS was associated with an increased odds ratio of suicide risk of approximately 2.4. After controlling for depressive symptoms however, presence of OCS was no longer a significant risk factor. Of the OCS assessed, only obsessions about speaking or acting violently remained an independent risk factor for suicidality over and above depression. [25]

A study of 36,788 OCD patients in the Swedish National Patient Register between 1969 and 2013 found that after adjusting for psychiatric comorbidities, the risk was reduced but remained substantial for both death by suicide and attempted suicide. Within the OCD cohort, a previous suicide attempt was the strongest predictor of death by suicide. Having a comorbid personality or substance use disorder also increased the risk of suicide. Being a woman, higher parental education and having a comorbid anxiety disorder were protective factors. Data show that patients with OCD are at a substantial risk of suicide. [26]

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