Association of OCD with a History of Traumatic Events Among Patients in Methadone Maintenance Treatment

Abstract

We studied the relationship between obsessive-compulsive disorder (OCD) and lifetime history of any traumatic events among methadone maintenance treatment (MMT) patients. In a cross-sectional sample of 167 patients, we clinically assessed for OCD using the Yale-Brown Obsessive Compulsive Scale and interviewed for their lifetime history of traumas. OCD was defined among 40.1% patients. Sixteen percent of patients reported having been victims of sexual abuse or rape, 21.6% had self-inflicted physical injuries, 34.1% attempted suicide, 44.9% sustained other physical violence or abuse, 28.7% were involved in a car accident as drivers and 6% as passengers, and 16.8% had significant falls. Patients with OCD compared with patients without OCD included more rape victims (28.4% vs. 9%), had more self-inflicted physical injuries (31.3% vs. 15%), and had more suicide attempts (46.3% vs. 26%), with no differences in other traumatic events exposure. The OCD group was characterized as being female (OR = 4.0 [95% CI 1.7-9.3]), having a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text-Revision Axis I psychiatric disorder (OR = 2.6 [95% CI 1.2-5.51]), being Israeli born (OR = 2.9 [95% CI 1.2-6.9]), abusing benzodiazepines (OR = 2.2 [95% CI 1.02-4.6]), having attempted suicide (OR = 2.5 [95% CI 1.1-5.4]), and having longer duration of opiate abuse before admission to MMT (OR =1.06 [95% CI 1.01-1.11). Awareness of this profile and specific interventions are needed in order to identify and help patients at risk, especially in preventing additional suicide attempts.