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Case Reports in Psychiatry
Volume 2017, Article ID 4808275, 7 pages
https://doi.org/10.1155/2017/4808275
Case Report

Obsessive-Compulsive Disorder with Suicide Obsessions in a First Responder without Previous Diagnosis of OCD or History of Suicide Attempts

1Texas Tech University Health Sciences Center School of Medicine, Department of Psychiatry, Lubbock, TX, USA
2Texas Tech University Health Sciences Center School of Medicine and Graduate School of Biomedical Sciences, MD/PhD Program, Lubbock, TX, USA
3Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX, USA

Correspondence should be addressed to Vivekananda Rachamallu; ude.cshutt@ullamahcar.adnanakeviv

Received 24 April 2017; Revised 23 July 2017; Accepted 24 August 2017; Published 2 October 2017

Academic Editor: Erik Jönsson

Copyright © 2017 Vivekananda Rachamallu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Obsessive-compulsive disorder (OCD) is a distressing and often debilitating disorder characterized by obsessions, compulsions, or both that are time-consuming and cause impairment in social, occupational, or other areas of functioning. There are many published studies reporting higher risk of suicidality in OCD patients, as well as studies describing increased risk of suicidality in OCD patients with other comorbid psychiatric conditions such as major depressive disorder (MDD) and posttraumatic stress disorder (PTSD). Existing case reports on OCD with suicide as the obsessive component describe patients with long standing diagnosis of OCD with suicidal ideations or previous suicide attempts. This report describes the case of a 28-year-old male, who works as a first responder, who presented with new onset symptoms characteristic of MDD and PTSD, with no past history of OCD or suicidality who developed OCD with suicidal obsessions. Differentiating between suicidal ideation in the context of other psychiatric illnesses and suicidal obsessions in OCD is critical to ensuring accurate diagnosis and timely provision of most appropriate treatment. The combination of exposure and response prevention therapy and pharmacotherapy with sertraline and olanzapine was effective in helping the patient manage the anxiety and distress stemming from the patient’s OCD with suicidal obsession.