Early maladaptive schemas and suicidal risk in an Iranian sample of patients with obsessive-compulsive disorder.

There are few studies on suicidal risk and its related factors in patients diagnosed with obsessive-compulsive disorder (OCD). This study investigated the associations of early maladaptive schemas, OC symptom dimensions, OCD severity, depression and anxiety with suicidality (i.e., suicidal ideation and suicide attempts) in OCD patients. Sixty OCD outpatients completed the Scale for Suicide Ideation (SSI), the Young Schema Questionnaire-Short Form (YSQ-SF), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Dimensional Obsessive-Compulsive Scale (DOCS) and the Depression Anxiety Stress Scales (DASS-21). 51.7% of patients had lifetime suicide attempts and 75% had suicidal ideation. OCD patients with lifetime suicide attempts exhibited significantly higher scores on early maladaptive schemas than those without such attempts. Logistic regression analysis revealed that the mistrust/abuse schema and the OC symptom dimension of unacceptable thoughts explained lifetime suicide attempts. The mistrust/abuse schema, unacceptable thoughts and depression significantly predicted suicidal ideation. These findings indicated that the mistrust/abuse schema may contribute to high suicidality in OCD patients. Also, patients suffering from unacceptable thoughts need to be assessed more carefully for warning signs of suicide.

Khosravani V ，Sharifi Bastan F ，Samimi Ardestani M ，Jamaati Ardakani R ... -  《-》

The relation of childhood trauma to suicide ideation in patients suffering from obsessive-compulsive disorder with lifetime suicide attempts.

The aim of this study was to evaluate the relations of childhood trauma (CT) and obsessive-compulsive (OC) symptom dimensions to suicide ideation in patients with obsessive-compulsive disorder (OCD). Seventy OCD outpatients with lifetime suicide attempts and 60 controls were included. Participants completed the Scale for Suicide Ideation (SSI), the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Dimensional Obsessive-Compulsive Scale (DOCS) and the Depression Anxiety Stress Scales (DASS-21). Among OCD patients, 97.1% had current suicide ideation. OCD patients revealed higher scores on CT, suicide ideation, depression and anxiety than controls. The CT history of sexual abuse (SA) and OC symptom dimension of unacceptable thoughts explained suicide ideation. It was concluded that SA and unacceptable thoughts may contribute to high suicidality and have important implications for the assessment and treatment of suicide risk in OCD patients with lifetime suicide attempts.

Khosravani V ，Kamali Z ，Jamaati Ardakani R ，Samimi Ardestani M ... -  《-》

Alexithymia and perfectionism traits are associated with suicidal risk in patients with obsessive-compulsive disorder.

There is limited evidence on suicidality and its associated factors in patients with obsessive-compulsive disorder (OCD). The present study investigated the potential contributing traits such as alexithymia and perfectionism and clinical risk factors including symptom dimensions associated with high suicidality in OCD patients. A total of 81 patients with OCD were included (mean age: 28.89 years, SD=7.95 years, 62% men). Suicidal risk was assessed using the Scale for Suicide Ideation and history taking. To assess alexithymia and perfectionism, the Toronto Alexithymia Scale-20 and the Measure of Constructs Underlying Perfectionism were applied. Clinical characteristics of OCD were assessed with the Yale-Brown Obsessive-Compulsive Scale, the Dimensional Obsessive-Compulsive Scale, and the Montgomery-Asberg Depression Rating Scale. Among OCD patients, 37% had a history of previous suicidal attempt, and 56.8% had current suicidal ideation. Those with lifetime suicide attempts scored significantly higher for alexithymia and ego-dystonic perfectionism than those without such history. In the binary logistic regression analysis, high score for alexithymia and the responsibility for harm, injury, or bad luck were significant determinants for lifetime suicide attempts. As for current suicide ideation, ego-dystonic perfectionism and the dimension of unacceptable thought were significant predictors of suicidal risk. The classification of suicidal risk and personality traits relied on self-report measures. The present findings indicate that personality traits such as alexithymia and perfectionism may contribute to high suicidality in patients with OCD, and patients suffering with unacceptable thoughts need to be assessed more carefully for warning signs of suicide.

Kim H ，Seo J ，Namkoong K ，Hwang EH ，Sohn SY ，Kim SJ ，Kang JI ... -  《-》

The suicidality continuum in a large sample of obsessive-compulsive disorder (OCD) patients.

Obsessive-compulsive disorder (OCD) has a chronic course leading to huge impact in the patient's functioning. Suicidal thoughts and attempts are much more frequent in OCD subjects than once thought before. To empirically investigate whether the suicidal phenomena could be analyzed as a suicidality severity continuum and its association with obsessive-compulsive (OC) symptom dimensions and quality of life (QoL), in a large OCD sample. Cross-sectional study with 548 patients diagnosed with OCD according to the DSM-IV criteria, interviewed in the Brazilian OCD Consortium (C-TOC) sites. Patients were evaluated by OCD experts using standardized instruments including: Yale-Brown Obsessive-Compulsive Scale (YBOCS); Dimensional Yale-Brown Obsessive-Compulsive Scale (DYBOCS); Beck Depression and Anxiety Inventories; Structured Clinical Interview for DSM-IV (SCID); and the SF-36 QoL Health Survey. There were extremely high correlations between all the suicidal phenomena. OCD patients with suicidality had significantly lower QoL, higher severity in the "sexual/religious", "aggression" and "symmetry/ordering" OC symptom dimensions, higher BDI and BA scores and a higher frequency of suicide attempts in a family member. In the regression analysis, the factors that most impacted suicidality were the sexual dimension severity, the SF-36 QoL Mental Health domain, the severity of depressive symptoms and a relative with an attempted suicide history. Suicidality could be analyzed as a severity continuum and patients should be carefully monitored since they present with suicidal ideation. Lower QoL scores, higher scores on the sexual dimension and a family history of suicide attempts should be considered as risk factors for suicidality among OCD patients.

Velloso P ，Piccinato C ，Ferrão Y ，Aliende Perin E ，Cesar R ，Fontenelle L ，Hounie AG ，do Rosário MC ... -  《-》

Relationship between early maladaptive schemas and symptom dimensions in patients with obsessive-compulsive disorder.

The aims of this study were to evaluate early maladaptive schemas (EMSs) of patients with obsessive-compulsive disorder (OCD) and to clarify relationships between particular EMSs and the five factor-analyzed symptom dimensions and other clinical variables. Fifty-seven patients with OCD and 70 normal controls completed the Young Schema Questionnaire, the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Y-BOCS symptom checklist, and the Beck Depression Inventory. Patients with OCD had significantly higher scores for schema related to defectiveness/shame, social isolation/alienation, and failure than did normal controls. Among the five OCD symptom dimensions, the sexual/religious dimension was only significantly correlated with two schemas of vulnerability to harm or illness and enmeshment/undeveloped self. These two schemas were significant predictors of the sexual/religious dimension, accounting for 33% of the total variance in this dimension. Any EMSs in patients with OCD were not related to clinical variables such as severity of OCD and duration of illness. These findings may constitute evidence to improve our understandings of OCD from a perspective of schema theory.

Kim JE ，Lee SW ，Lee SJ 《-》