Major depressive episodes (MDEs) are associated with suicidal ideation and suicidal behaviors, and comparably, body dysmorphic disorder (BDD) is significantly associated with suicidal ideation and suicidal behaviors, according to a study published in the Journal of Affective Disorders. Furthermore, although bipolar depression was associated with suicidal ideation and marginally associated with suicidal behaviors, unipolar depression was only associated with suicidal ideation.
This study examined the possible associations between anxiety, mood, and obsessive-compulsive spectrum disorders and suicidal ideation and behaviors in a sample of patients from the Behavioral Health Partial Program at McLean Hospital (N=498; 55.2% women; 88% white, 3% black, 8% Asian, 4% other races; average age 34.8 years [SD=14.4, range=18-74]). Data on current diagnosis and past-month suicidal ideation and behaviors were assessed by semi-structured interviews.
After adjustments were made for sex, age, and other psychiatric disorders, multivariant analysis demonstrated that body dysmorphic disorder was significantly associated with suicidal ideation (OR, 6.62; 95% CI, 1.92-22.79; P =.003) and suicidal behaviors (OR, 2.45; 95% CI, 1.05-5.71; P =.038). Similarly, episodes of major depression were associated with suicidal ideation and suicidal behaviors. While bipolar depression was associated with suicidal ideation (OR, 2.71; 95% CI, 1.36-5.40; P =.005) and was marginally associated with suicidal behaviors (OR, 2.02; 95% CI, 0.99-4.13; P =.054), unipolar depression was only associated with suicidal ideation (OR, 1.82; 95% CI, 1.20–2.74; P =.005). After controlling for comorbid disorders, no association was found between suicidality and obsessive-compulsive disorder, anxiety disorders, or post-traumatic stress disorder.
Although there were limitations to the study, such as the cross-sectional design and the low base rates of certain disorders, which led to a relatively small sample size, study investigators concluded that, “MDE and BDD have unique relationships with suicidality in a partial hospital setting that is independent of other internalizing disorders. BDD is a common and often underrecognized disorder (Zimmerman and Mattia, 1998), and clinicians should be aware of elevated risk of suicidality in this population. Further research is needed to better understand the nature of the relationship between BDD and suicidality, and whether the results generalize to other clinical settings.”
Snorrason I, Beard C, Christensen K, Bjornsson AS, Björgvinsson T. Body dysmorphic disorder and major depressive episode have comorbidity-independent associations with suicidality in an acute psychiatric setting [published online August 19, 2019]. J Affect Disord. doi: 10.1016/j.jad.2019.08.059