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Directionality of change in obsessive compulsive disorder (OCD) and suicidal ideation over six years in a naturalistic clinical sampleā°
- Source :
- Journal of Affective Disorders. 245:841-847
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- Background Obsessive compulsive disorder (OCD) is associated with elevated suicide risk, but the directionality of the association between OCD severity and suicidal ideation has not been established, which was the goal of this study. Methods Participants (n = 325) were adults with either a current or past diagnosis of Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) OCD who were assessed annually for suicidal ideation and OCD symptom severity for six years. Cross-lagged panel analyses statistically compared unidirectional and bidirectional models over time. Serious suicide-related adverse events were reported. Results The best-fitting and most parsimonious model included paths predicting suicidal ideation from OCD symptom severity, but not vice versa. These results were confirmed by comparing a model with cross-lagged paths constrained equal to a freely estimated model. Higher OCD symptom severity in a given year was associated with a higher suicidal ideation severity in the subsequent year. Five suicide-related adverse events were reported throughout the duration of the study, including two suicide deaths and three suicide attempts. Limitations The study relied on a single-item, annual measure of suicidal ideation in adults, with substantial variability in severity of suicide risk, and missing data increased with later observations in the study. Discussion OCD symptom severity predicted next year suicidal ideation severity. In contrast, suicidal ideation severity in a given year did not predict next-year OCD symptom severity in this OCD sample. Thus, rather than waiting for suicidal ideation to resolve, clinicians should consider providing empirically supported treatments for OCD.
- Subjects :
- Adult
Male
Obsessive-Compulsive Disorder
Evidence-based practice
Suicide, Attempted
macromolecular substances
behavioral disciplines and activities
Article
Suicidal Ideation
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
Obsessive compulsive
mental disorders
medicine
Humans
Longitudinal Studies
Prospective Studies
Adverse effect
Suicide Risk
Suicidal ideation
Obsessive-compulsive disorder (OCD)
business.industry
Symptom severity
Middle Aged
medicine.disease
030227 psychiatry
Diagnostic and Statistical Manual of Mental Disorders
Psychiatry and Mental health
Clinical Psychology
Socioeconomic Factors
Disease Progression
Regression Analysis
Anxiety
Female
medicine.symptom
business
030217 neurology & neurosurgery
Clinical psychology
Subjects
Details
- ISSN :
- 01650327
- Volume :
- 245
- Database :
- OpenAIRE
- Journal :
- Journal of Affective Disorders
- Accession number :
- edsair.doi.dedup.....1f4effb6098c81dceadd50071512a7d9