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        Suicide attempts and suicidal ideation in patients with obsessive-compulsive disorder : A systematic review and meta-analysis

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        Author
        Pellegrini, Luca
        Maietti, Elisa
        Rucci, Paola
        Casadei, Giacomo
        Maina, Giuseppe
        Fineberg, Naomi A.
        Albert, Umberto
        Attention
        2299/23445
        Abstract
        Introduction: There is controversy on the magnitude of suicide risk in OCD and on the psychopathological features that raise the risk. This systematic review and meta-analysis aims to estimate the pooled prevalence of suicide attempts and suicidal ideation (current/lifetime) in subjects with OCD and identify sociodemographic and clinical factors associated with greater risk. Methods: We conducted a literature search in PubMed/Medline, PsycINFO, Web of Science and CINAHL databases up to June 20, 2019, according to PRISMA guidelines. Stata statistical software (Version 15) was used to obtain forest plots, execute subgroup analyses and perform univariate and multivariate meta-regressions. Results: We found 61 eligible studies including OCD patients: 52 investigated suicide attempts and reported a pooled prevalence of 0.135 (95% CI 0.123–0.147); 26 explored current suicidal ideation and reported a pooled prevalence of 0.273 (95% CI 0.214–0.335); 22 researched lifetime suicidal ideation and reported a pooled prevalence of 0.473 (95% CI 0.397–0.548). Severity of obsessions, comorbid substance use and depressive/anxious symptoms increased the risk, whereas compulsions had a comparatively protective effect. Limitations: Owing to the small number of studies reporting completed suicide rates, this metric was not included in the meta-analysis. The degree of heterogeneity between the studies was high. Conclusion: Clinicians should keep in mind that one out of ten patients with OCD attempts suicide during his/her lifetime, about one third has current suicidal ideation and about half has had suicidal ideation in the past. Several clinical features are associated with increased risk and should be factored into clinical risk management.
        Publication date
        2020-11-01
        Published in
        Journal of Affective Disorders
        Published version
        https://doi.org/10.1016/j.jad.2020.07.115
        License
        http://creativecommons.org/licenses/by-nc-nd/4.0/
        Other links
        http://hdl.handle.net/2299/23445
        Relations
        School of Life and Medical Sciences
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