How Do Suicide Risks Differ Between OCD Patients With and Without Tics?

What you need to know

• Patients with OCD who also have tics (OCTD) showed higher rates of suicide attempts compared to those with OCD alone
• The OCTD group with previous suicide attempts had more severe illness features, including earlier age of onset and more psychiatric conditions occurring together
• Treatment was more challenging in OCTD patients with suicide attempts, with lower response rates to medications and higher treatment resistance

Understanding OCD With and Without Tics

Obsessive-compulsive disorder (OCD) is a condition where people experience unwanted, intrusive thoughts (obsessions) and feel compelled to perform repetitive behaviors (compulsions) to reduce anxiety. Some people with OCD also have tics - sudden, rapid, repetitive movements or vocalizations. When OCD occurs with tics, it is called obsessive-compulsive tic-related disorder (OCTD).

This large study examined over 300 patients across nine psychiatric centers in Italy to better understand suicide risk in people with OCD versus OCTD. The researchers looked at both suicidal thoughts (ideation) and actual suicide attempts.

Key Findings About Suicide Risk

While both groups had similar rates of suicidal thoughts (around 24-25%), people with OCTD had a higher rate of actual suicide attempts (16%) compared to those with OCD alone (13%). This suggests that having tics along with OCD may increase the risk of acting on suicidal thoughts.

The researchers found several important differences in OCTD patients who had attempted suicide:

• They were more likely to be male
• They had higher unemployment rates
• They developed psychiatric conditions at an earlier age
• They were more likely to have multiple psychiatric conditions occurring together
• They had higher rates of family history of mental health conditions
• They needed more medications but showed poorer response to treatment

Understanding Treatment Challenges

Treatment was particularly challenging in OCTD patients with previous suicide attempts. They required both antidepressants and antipsychotic medications at higher rates, yet showed lower response rates to treatment compared to other groups. About 32% were considered “treatment resistant,” meaning multiple medication trials had not adequately improved their symptoms.

The Role of Family Support

The study found that OCTD patients with suicide attempts needed more family involvement in their care compared to other groups. This highlights the importance of family support networks in managing severe cases of OCTD. However, these patients also reported lower quality of life despite having more family support, suggesting the significant burden of their symptoms.

Conclusions

• Having tics along with OCD appears to increase risk for suicide attempts
• Early identification of risk factors like early onset, multiple conditions, and family history is crucial
• Treatment may need to be more intensive for OCTD patients with suicide risk
• Family support is important but may not be sufficient without proper medical treatment

These findings emphasize the need for mental health professionals to carefully assess suicide risk in OCTD patients and consider more comprehensive treatment approaches. The involvement of both medical professionals and family support networks appears crucial for managing severe cases.