Pathways to suicidal risk in patients with OCD: The role of childhood abuse, cognitive vulnerabilities, OCD symptomology, and depression

Childhood maltreatment (CM) and its associated cognitive vulnerabilities, such as early maladaptive schemas (EMSs), have been identified as dysfunctional and risk factors for obsessive-compulsive disorder (OCD) and its related clinical outcomes, including obsessive-compulsive (OC) symptoms, depression, and suicidality. However, the combined effects of these variables on suicidal risk have not been investigated yet. This study aimed to examine the relationships between CM and suicidal risk through the paths of EMS domains, OCD symptoms, and depression in patients with OCD (n = 300). Participants completed a series of self-report scales assessing the psychological and clinical variables. The results showed a significant relationship between childhood emotional abuse and suicidal ideation, which was mediated by the paths of disconnection/rejection, unacceptable obsessional thoughts, and depression. These findings suggest that individuals with OCD who have experienced childhood emotional abuse may exhibit heightened levels of disconnection/rejection, frequent repugnant obsessions, and depressive mood, possibly contributing to an increased risk of suicide. Therefore, it is crucial for therapeutic settings, such as schema therapy, to carefully assess and monitor these risk factors in order to prevent suicidal risk in individuals with OCD.