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Suicidal ideation and suicidal attempts in patients with obsessive-compulsive tic-related disorder vs obsessive-compulsive disorder: results of a multicenter Italian study

Published online by Cambridge University Press:  06 May 2020

Beatrice Benatti Open the ORCID record for Beatrice Benatti [Opens in a new window] ,
Silvia Ferrari ,
Benedetta Grancini ,
Nicolaja Girone ,
Matteo Briguglio ,
Donatella Marazziti Open the ORCID record for Donatella Marazziti [Opens in a new window] ,
Federico Mucci ,
Liliana Dell’Osso ,
Orsola Gambini  and
Benedetta Demartini
...Show all authors
Beatrice Benatti*
Affiliation:
Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy
Silvia Ferrari
Affiliation:
Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy
Benedetta Grancini
Affiliation:
Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy
Nicolaja Girone
Affiliation:
Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy
Matteo Briguglio
Affiliation:
IRCCS Orthopedic Institute Galeazzi, Department of Functional Neurosurgery, Tourette Center, Milan, Italy
Donatella Marazziti
Affiliation:
Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
Federico Mucci
Affiliation:
Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
Liliana Dell’Osso
Affiliation:
Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
Orsola Gambini
Affiliation:
Department of Health Sciences, University of Milan, Milan, Italy “Aldo Ravelli” Center for Nanotechnology and Neurostimulation, University of Milan, Milan, Italy
Benedetta Demartini
Affiliation:
Department of Health Sciences, University of Milan, Milan, Italy “Aldo Ravelli” Center for Nanotechnology and Neurostimulation, University of Milan, Milan, Italy
Antonio Tundo
Affiliation:
Institute of Psychopathology, Rome, Italy
Roberta Necci
Affiliation:
Institute of Psychopathology, Rome, Italy
Domenico De Berardis
Affiliation:
NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital “G. Mazzini”, Teramo, Italy Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University “G. D’Annunzio”, Chieti, Italy
Roberta Galentino
Affiliation:
IRCCS Orthopedic Institute Galeazzi, Department of Functional Neurosurgery, Tourette Center, Milan, Italy
Sara De Michele
Affiliation:
IRCCS Orthopedic Institute Galeazzi, Department of Functional Neurosurgery, Tourette Center, Milan, Italy
Umberto Albert
Affiliation:
Dipartimento Universitario Clinico di Scienze Mediche Chirurgiche e della Salute, Università degli Studi di Trieste, Trieste, Italy; SC Clinica Psichiatrica, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), Trieste, Italy
Sylvia Rigardetto
Affiliation:
San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
Giuseppe Maina
Affiliation:
San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
Giacomo Grassi
Affiliation:
Brain Center Firenze, Florence, Italy
Stefano Pallanti
Affiliation:
Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
Andrea Amerio
Affiliation:
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy IRCCS Ospedale Policlinico San Martino, Genoa, Italy Mood Disorders Program, Tufts Medical Center, Boston, Massachusetts, USA
Mario Amore
Affiliation:
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy IRCCS Ospedale Policlinico San Martino, Genoa, Italy
Alberto Priori
Affiliation:
Department of Health Sciences, University of Milan, Milan, Italy “Aldo Ravelli” Center for Nanotechnology and Neurostimulation, University of Milan, Milan, Italy
Domenico Servello
Affiliation:
IRCCS Orthopedic Institute Galeazzi, Department of Functional Neurosurgery, Tourette Center, Milan, Italy
Caterina Viganò
Affiliation:
Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy
Monica Bosi
Affiliation:
Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy
Anna Colombo
Affiliation:
Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy
Mauro Porta
Affiliation:
IRCCS Orthopedic Institute Galeazzi, Department of Functional Neurosurgery, Tourette Center, Milan, Italy
Bernardo Dell’Osso
Affiliation:
Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy “Aldo Ravelli” Center for Nanotechnology and Neurostimulation, University of Milan, Milan, Italy Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA Centro per lo studio dei meccanismi molecolari alla base delle patologie neuro-psico-geriatriche”, University of Milan, Milan, Italy
*
*Beatrice Benatti, MD, Email: beatricebenatti@gmail.com
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Abstract

Background

Obsessive-compulsive disorder (OCD) and tic disorder (TD) represent highly disabling, chronic and often comorbid psychiatric conditions. While recent studies showed a high risk of suicide for patients with OCD, little is known about those patients with comorbid TD (OCTD). Aim of this study was to characterize suicidal behaviors among patients with OCD and OCTD.

Methods

Three hundred and thirteen outpatients with OCD (n = 157) and OCTD (n = 156) were recruited from nine different psychiatric Italian departments and assessed using an ad-hoc developed questionnaire investigating, among other domains, suicide attempt (SA) and ideation (SI). The sample was divided into four subgroups: OCD with SA (OCD-SA), OCD without SA (OCD-noSA), OCTD with SA (OCTD-SA), and OCTD without SA (OCTD-noSA).

Results

No differences between groups were found in terms of SI, while SA rates were significantly higher in patients with OCTD compared to patients with OCD. OCTD-SA group showed a significant male prevalence and higher unemployment rates compared to OCD-SA and OCD-noSA sample. Both OCTD-groups showed an earlier age of psychiatric comorbidity onset (other than TD) compared to the OCD-SA sample. Moreover, patients with OCTD-SA showed higher rates of other psychiatric comorbidities and positive psychiatric family history compared to the OCD-SA group and to the OCD-noSA groups. OCTD-SA and OCD-SA samples showed higher rates of antipsychotics therapies and treatment resistance compared to OCD-noSA groups.

Conclusions

Patients with OCTD vs with OCD showed a significantly higher rate of SA with no differences in SI. In particular, OCTD-SA group showed different unfavorable epidemiological and clinical features which need to be confirmed in future prospective studies.

Keywords

Obsessive-compulsive disordertic disordersuicidality
Type
Original Research
Information
CNS Spectrums , Volume 26 , Issue 4 , August 2021 , pp. 354 - 361
Copyright
© The Author(s) 2020. Published by Cambridge University Press

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References

Dell’Osso, B, Benatti, B, Hollander, E, et al. Socio-demographic and clinical characterization of patients with obsessive-compulsive tic-related disorder (OCTD): an Italian multicenter study. J Psychopathol. 2018;24(3):148–153.Google Scholar
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed.. Arlington, VA: American Psychiatric Association; 2013.Google Scholar
Zohar, J. OCD: towards DSM-V. Int J Psychiatry Clin Pract. 2007;11(Suppl 2):1–4.CrossRefGoogle ScholarPubMed
Kloft, L, Steinel, T, Kathmann, N. Systematic review of co-occurring OCD and TD: evidence for a tic-related OCD subtype? Neurosci Biobehav Rev. 2018;95:280–314. doi:10.1016/j.neubiorev.2018.09.021.CrossRefGoogle ScholarPubMed
Pinto, R, Monzani, B, Leckman, JF, et al. Understanding the covariation of tics, attention-deficit/hyperactivity, and obsessive-compulsive symptoms: a population-based adult twin study. Am J Med Genet B Neuropsychiatr Genet. 2016;171(7):938–947.CrossRefGoogle ScholarPubMed
Yu, D, Mathews, CA, Scharf, JM, et al. Cross-disorder genome-wide analyses suggest a complex genetic relationship between Tourette’s syndrome and OCD. Am J Psychiatry. 2015;172(1):82–93.CrossRefGoogle ScholarPubMed
Dell’Osso, B, Marazziti, D, Albert, U, et al. Parsing the phenotype of obsessive-compulsive tic disorder (OCTD): a multidisciplinary consensus. Int J Psychiatry Clin Pract. 2017;21(2):156–159.10.1080/13651501.2017.1291822CrossRefGoogle ScholarPubMed
Amerio, A, Stubbs, B, Odone, A, Tonna, M, Marchesi, C, Ghaemi, SN. Bipolar I and II disorders: a systematic review and meta-analysis on differences in comorbid obsessive-compulsive disorder. Iran J Psychiatry Behav Sci. 2016;10(3):e3604.CrossRefGoogle ScholarPubMed
Angelakis, I, Gooding, P, Tarrier, N, Panagioti, M. Suicidality in obsessive compulsive disorder (OCD): a systematic review and meta-analysis. Clin Psychol Rev. 2015;39:1–15.CrossRefGoogle ScholarPubMed
Angelakis, I, Gooding, P. Obsessive-compulsive disorder and suicidal experiences: the role of experiential avoidance. Suicide Life Threat Behav. 2019. http://www.ncbi.nlm.nih.gov/pubmed/31553082.Google ScholarPubMed
Fernández de la Cruz, L, Rydell, M, Runeson, B, et al. Suicide in Tourette’s and chronic tic disorders. Biol Psychiatry. 2017;82(2):111–8. doi:10.1016/j.biopsych.2016.08.023.CrossRefGoogle ScholarPubMed
Albert, U, De Ronchi, D, Maina, G, Pompili, M. Suicide risk in obsessive-compulsive disorder and exploration of risk factors: a systematic review. Curr Neuropharmacol. 2019;17(8):681–696.CrossRefGoogle ScholarPubMed
Kamath, P, Reddy, YCJ, Kandavel, T. Suicidal behavior in obsessive-compulsive disorder. J Clin Psychiatry. 2007;68(11):1741–1750.CrossRefGoogle ScholarPubMed
Velloso, P, Piccinato, C, Ferrão, Y, et al. The suicidality continuum in a large sample of obsessive–compulsive disorder (OCD) patients. Eur Psychiatry. 2016;38:1–7.CrossRefGoogle Scholar
Narayanaswamy, JC, Viswanath, B, Veshnal Cherian, A, Bada Math, S, Kandavel, T, Janardhan Reddy, YC. Impact of age of onset of illness on clinical phenotype in OCD. Psychiatry Res. 2012;200(2–3):554–559.CrossRefGoogle ScholarPubMed
First, MB, Spitzer, RL, Gibbon, M, Williams, JB. Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition (SCID-I/P). New York, NY: New York Biometrics Research; 2002.Google Scholar
First, M, Gibbon, M, Spitzer, R, Williams, J, Benjamin, L. Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II). Washington DC: American Psychiatric Press; 1997.Google Scholar
Goodman, WK, Price, LH, Rasmussen, SA, et al. The Yale-Brown Obsessive Compulsive Scale. I. Development, use, and reliability. Arch Gen Psychiatry. 1989;46(11):1006–1011.CrossRefGoogle ScholarPubMed
Roessner, V, Becker, A, Banaschewski, T, Rothenberger, A. Tic disorders and obsessive compulsive disorder: where is the link? J Neural Transm Suppl. 2005;(69):69–99.Google ScholarPubMed
Storch, EA, Hanks, CE, Mink, JW, et al. Suicidal thoughts and behaviors in children and adolescents with chronic tic disorders. Depress Anxiety. 2015;32(10):744–753.CrossRefGoogle ScholarPubMed
Dell’Osso, B, Benatti, B, Arici, C, et al. Prevalence of suicide attempt and clinical characteristics of suicide attempters with obsessive-compulsive disorder: a report from the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS). CNS Spectr. 2018;23(1):59–66.CrossRefGoogle Scholar
Alonso, P, Segalàs, C, Real, E, et al. Suicide in patients treated for obsessive-compulsive disorder: a prospective follow-up study. J Affect Disord. 2010;124(3):300–308.CrossRefGoogle ScholarPubMed
Balci, V, Sevincok, L. Suicidal ideation in patients with obsessive-compulsive disorder. Psychiatry Res. 2010;175(1–2):104–108.CrossRefGoogle ScholarPubMed
Fontenelle, IS, Fontenelle, LF, Borges, MC, et al. Quality of life and symptom dimensions of patients with obsessive-compulsive disorder. Psychiatry Res. 2010;179(2):198–203. doi:10.1016/j.psychres.2009.04.005.CrossRefGoogle ScholarPubMed
Moritz, S. A review on quality of life and depression in obsessive-compulsive disorder. CNS Spectr. 2008;13(9 Suppl 14):16–22.CrossRefGoogle ScholarPubMed
Taylor, S. Early versus late onset obsessive–compulsive disorder: evidence for distinct subtypes. Clin Psychol Rev. 2011;31(7):1083–1100.CrossRefGoogle ScholarPubMed
de Mathis, MA, Diniz, JB, Hounie, AG, et al. Trajectory in obsessive-compulsive disorder comorbidities. Eur Neuropsychopharmacol. 2013;23(7):594–601.CrossRefGoogle ScholarPubMed
Fernández de la Cruz, L, Rydell, M, Runeson, B, et al. Suicide in obsessive–compulsive disorder: a population-based study of 36 788 Swedish patients. Mol Psychiatry. 2016;22:1–7. doi:10.1038/mp.2016.115.Google ScholarPubMed
Walsh, KH, McDougle, CJ. Psychotherapy and medication management strategies for obsessive-compulsive disorder. Neuropsychiatr Dis Treat. 2011;7:485–494.CrossRefGoogle ScholarPubMed
Hantouche, EG, Demonfaucon, C. Toc résistant: caractéristiques cliniques, facteurs prédictifs et influence des tempéraments affectifs. Encephale. 2008;34(6):611–617.CrossRefGoogle Scholar
Erbuto, D, Innamorati, M, Lamis, DA, et al. Mediators in the association between affective temperaments and suicide risk among psychiatric inpatients. Psychiatry. 2018;81(3):240–257. doi:10.1080/00332747.2018.1480251.CrossRefGoogle ScholarPubMed
Akiskal, HS, Akiskal, KK, Haykal, RF, Manning, JS, Connor, PD. TEMPS-A: progress towards validation of a self-rated clinical version of the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Autoquestionnaire. J Affect Disord. 2005;85(1–2):3–16.CrossRefGoogle ScholarPubMed
Beck, AT, Weissman, A, Lester, D, Trexler, L. The measurement of pessimism: the Hopelessness Scale. J Consult Clin Psychol. 1974;42(6):861–865.CrossRefGoogle ScholarPubMed
Shneidman, ES. The psychological pain assessment scale. Suicide Life Threat Behav. 1999;29(4):287–294.Google ScholarPubMed
Hausberg, MC, Schulz, H, Piegler, T, et al. Is a self-rated instrument appropriate to assess mentalization in patients with mental disorders? Development and first validation of the mentalization questionnaire (MZQ). Psychother Res. 2012;22(6):699–709. doi:10.1080/10503307.2012.709325.CrossRefGoogle Scholar
Silverman, MM, Berman, AL, Sanddal, ND, O’Carroll, PW, Joiner, TE. Rebuilding the Tower of Babel: a revised nomenclature for the Study of Suicide and Suicidal Behaviors Part 2: suicide-related ideations, Commun Behav Suicide Life-Threatening Behav. 2007;37(3):264–277.CrossRefGoogle Scholar