Prevalence and correlates of suicidality in obsessive-compulsive disorder

A growing body of evidence suggest individuals with obsessive-compulsive disorder (OCD) are at an increased risk for suicidal thoughts and behaviors (SITB). However, the literature on suicidality in OCD remains limited. Thus, the present study examined the prevalence and predictors of suicidality in a sample of adults seeking treatment for OCD. A total of 687 patients seeking care through a network of intensive treatment centers consented to participate. Participants completed validated self-report questionnaires of depression and OCD symptom severity, as well as psychodiagnostic interviews. Almost half of the participants reported current suicidal ideation. The presence of a comorbid diagnosis was associated with increased likelihood of more severe SITB. Specifically, the presence of a co-occurring anxiety, depressive, or bipolar mood disorder predicted increased severity of SITB. In addition, obsession severity was positively associated with suicidality, while compulsion severity negatively predicted the severity of SITB. Regarding OCD symptom dimensions, repugnant thoughts emerged as a significant predictor of SITB severity. SITB is a prevalent concern in treatment-seeking patients with OCD. Clinicians are encouraged to assess and consider the treatment implications of SITB, particularly among patients with co-occurring mood and anxiety disorders, or symptoms involving taboo thought content. Future directions and theoretical considerations are discussed. •Nearly half of the patients with OCD reported suicidal thoughts or behaviors (SITB).•Having one or more comorbid diagnoses were associated with increased SITB severity.•Anxiety, depression, and bipolar mood disorders predicted SITB severity.•Examined simultaneously, obsessions positively and compulsions negatively predicted SITB severity.•OCD symptoms involving repugnant thoughts also uniquely predicted SITB.