Citation

Benvenuti A, Rucci P, Sbrana A, Ravani L, Massei GJ, Gonnelli C, Cassano GB. Ital. J. Psychopathol. 2009; 15(3): 282-289.

Copyright

(Copyright © 2009, Pacini editore)

DOI

unavailable

PMID

unavailable

Abstract

OBJECTIVE: The aims of this paper are to examine the lifetime frequency of obsessive compulsive disorder and of obsessive compulsive spectrum in patients with schizophrenia, psychotic mood disorders and non-psychotic mood disorders and to investigate the association of obsessive compulsive spectrum features with suicidality.

METHOD: Consecutive outpatients and inpatients with schizophrenia and mood disorders were recruited for a multicenter study aimed to assess the validity of the Structured Clinical Interview for the Psychotic Spectrum. The diagnostic assessment was conducted with the Structured Clinical Interview for DSM-IV Axis I Disorders. Lifetime obsessive compulsive spectrum features were assessed with the Obsessive-Compulsive Spectrum Self-Report questionnaire and suicidality was assessed using 6 items of the Mood Spectrum Self-Report questionnaire. Patients were classified into 6 mutually exclusive groups (no suicidality, only thoughts, ideation, plans, attempts, serious attempts) according to the highest level achieved in their lifetime.

RESULTS: The study sample was composed of 76 patients with schizophrenia or schizoaffective disorder (schizophrenia = 45; schizoaffective disorder = 31), 53 with psychotic mood disorders (psychotic mood disorders: 36 with bipolar I disorder; 17 with unipolar depression) and 92 with non-psychotic mood disorder (non-psychotic mood disorders: 23 with bipolar I disorder, 70 with unipolar depression) (Table I). Suicidality was more common in patients with mood disorders than in schizophrenia (Fig. 1). While 40% of patients with schizophrenia endorsed at least one suicidality item, this was the case in 62% of patients with psychotic mood disorders (of whom 26% committed a serious suicide attempt) and 56% of patients with non-psychotic mood disorders. In an ordinal regression model examining the effect on suicidality of obsessive-compulsive disorder, obsessive-compulsive spectrum self-report domains and study group, the domains 'Doubt' and 'obsessive-compulsive issues' predicted increased levels of suicidality while 'perfectionism' and schizophrenia (compared with non-psychotic mood disorders) predicted decreased levels of suicidality (Table III).

CONCLUSIONS: Obsessive compulsive spectrum features are common among patients with schizophrenia, schizoaffective disorders and mood disorders. Our findings highlight the importance of early recognition and treatment of these spectrum features as they are related to a higher suicidal risk. Further studies are warranted to confirm these findings and to better clarify the predictive and prognostic value of obsessive-compulsive spectrum features.

Language: en

Keywords

adult; human; Suicide; female; male; prognosis; bipolar disorder; Schizophrenia; suicidal ideation; sex difference; schizophrenia; psychosis; suicide attempt; major depression; suicidal behavior; clinical trial; Brief Psychiatric Rating Scale; comorbidity; disease severity; prediction; mood disorder; Mood disorders; outpatient; article; major clinical study; controlled study; questionnaire; risk; disease association; clinical feature; self report; lifespan; hospital patient; multicenter study; diagnostic test; recognition; schizoaffective psychosis; obsessive compulsive disorder; diagnostic and statistical manual of mental disorders; validity; structured interview; Obsessive compulsive spectrum