Compared with deaths by suicide, suicide attempts have been more extensively studied in the OCD literature. In a large epidemiological study in the United States (n=18 571), Hollander and colleagues15 reported that OCD sufferers without psychiatric comorbidity (n=140) had a significantly higher rate of self-reported lifetime suicide attempts compared with individuals without a mental disorder (3.6 vs 0.9%, odds ratio (OR)=3.2), while OCD cases with psychiatric comorbidity (n=266) had an even higher rate of lifetime suicide attempts than individuals with other mental disorders (15.0 vs 7.0% OR=2.2). Torres and colleagues16 identified 114 individuals with OCD in the British National Psychiatric Morbidity Survey of 2000—comprising 8580 individuals—and observed that 25% of OCD cases had self-reported at least one previous suicide attempt. In addition, studies conducted in specialist clinics have reported rates of suicide attempts ranging from 3 to 27%.12, 17, 18, 19 However, as concluded in a recent meta-analysis, the methodological quality of the previous literature on suicidal behavior in OCD has generally been poor.20
