Assessing suicide risk in patients with obsessive-compulsive disorder: a dimensional approach

Objectives: Although an association has been found recently between obsessive-compulsive disorder and an increased risk of suicide, the prevalence of both suicidal ideation and attempts vary considerably and are generally assessed categorically. Our aims were to evaluate the prevalence of suicidal ideation and behaviors using a dimensional approach. Methods: The sample included 129 patients with obsessive-compulsive disorder. Suicidality was assessed by administering the Columbia-Suicide Severity Rating Scale. Logistic and linear regres-sions were used to examine predictors of suicidal ideation, severe suicidal ideation, and suicidal behavior. Results: The lifetime prevalence of suicidal ideation and behaviors were 64.3% and 16.3%, respectively. Lifetime suicidal ideation was associated with the number of stressful life events, duration of illness, Hamilton Rating Scale for Depression scores, and family history of mood disorders. A family history of obsessive-compulsive disorder was associated with a lower probability of lifetime suicidal ideation. Severe suicidal ideation was related to greater severity of the most stressful life event, Hamilton Rating Scale for Depression scores, and longer duration of untreated illness. The probability of lifetime suicidal behavior was related to Hamilton Rating Scale for Anxiety scores, symmetry obsessions, and washing and checking compulsions. The probability of lifetime non-suicidal self-injurious behaviors was related to Hamilton Rating Scale for Anxiety scores. Conclusions: Recognizing predictors of suicidal ideation/behavior is crucial to identifying patients at greater risk

Socio-demographic and clinical characterization of patients with obsessive-compulsive tic-related disorder (OCTD) : An Italian multicenter study

© Copyright by Pacini Editore SrlIn the DSM-5 a new "tic-related" specifier for obsessive compulsive disorder (OCD) has been introduced, highlighting the importance of an accurate characterization of patients suffering from obsessive-compulsive tic-related disorder ("OCTD"). In order to characterize OCTD from a socio-demographic and clinical perspective, the present multicenter study was carried out. The sample consists of 266 patients, divided in two groups with lifetime diagnoses of OCD and OCTD, respectively. OCTD vs OCD patients showed a significant male prevalence (68.5% vs 48.5%; p < .001), a higher rate of psychiatric comorbidities (69.4 vs 50%; p < .001) - mainly with neurodevelopmental disorders (24 vs 0%; p < .001), a lower education level and professional status (middle school diploma: 25 vs 7.6%; full-Time job 44.4 vs 58%; p < .001). Moreover, OCTD vs OCD patients showed significantly earlier age of OCD and psychiatric comorbidity onsets (16.1 ± 10.8 vs 22.1 ± 9.5 years; p < .001, and 18.3 ± 12.8 vs 25.6 ± 9.4: p < .001, respectively). Patients with OCTD patients were treated mainly with antipsychotic and with a low rate of benzodiazepine (74.2 vs 38.2% and 20.2 vs 31.3%, respectively; p < .001). Finally, OCTD vs OCD patients showed higher rates of partial treatment response (58.1 vs 38%; p < .001), lower rates of current remission (35.5 vs 54.8%; p < .001) and higher rates of suicidal ideation (63.2 vs 41.7%; p < .001) and attempts (28.9 vs 8.3%; p < .001). Patients with OCTD report several unfavorable socio-demographic and clinical characteristics compared to OCD patients without a history of tic. Additional studies on larger sample are needed to further characterize OCTD patients from clinical and therapeutic perspectives.Peer reviewedFinal Published versio

Which patients benefit from adding short-term psychodynamic psychotherapy to antidepressants in the treatment of depression?: A systematic review and meta-analysis of individual participant data

Multivariate analysis of psychological dat

Caratteristiche sociodemografiche e cliniche del disturbo ossessivo-compulsivo in comorbilidità con il disturbo bipolare

Introduzione: Nei pazienti affetti da disturbo ossessivo-compulsivo (DOC) la comparsa di mani- festazioni psicopatologiche di tipo bipolare costituisce un rilevante problema clinico con importanti conseguenze a livello sia prognostico sia terapeutico, con tassi di comorbilità tra i due disturbi che arrivano fino al 30%. Lo scopo del presente studio è quello di evidenziare le differenze sociodemografiche e cliniche tra i pazienti affetti da DOC con e senza disturbo bipolare associato, con l’obiettivo di identificare possibili predittori che orientino nelle scelte terapeutiche. Materiali e metodi: Il campione, composto da pazienti con diagnosi principale di DOC, viene suddiviso per il confronto in un gruppo con DOC ‘‘puro’’ e in uno con associato disturbo bipolare. Risultati: Il campione è costituito da 290 pazienti affetti da DOC, di cui 259 senza disturbo bipolare associato e 31 con disturbo bipolare. Il profilo sociodemografico e clinico dei pazienti che presentano disturbo bipolare in associazione a DOC è caratterizzato da maggiore frequenza nel sesso maschile, più rilevante familiarità per disturbi dell’umore, più frequenti ossessioni sessuali e di accumulo e compulsioni di ripetizione e accumulo. Inoltre, emerge come signifi- cativa l’associazione con disturbo da uso di sostanze e, per quanto riguarda la comorbilità di Asse II, con disturbo ossessivo-compulsivo di personalità. Conclusioni: I risultati emersi evidenziano specifiche differenze tra i soggetti affetti da DOC con o senza disturbo bipolare in comorbilità e indirizzano verso la possibile identificazione di sottogruppi di pazienti DOC con caratteristiche specifiche, con possibili differenti basi eziopa- togenetiche e per i quali è necessario studiare specifici approcci terapeutici