Sexual and religious obsessions in relation to suicidal ideation in bipolar disorder

Objectives
Obsessions and suicidal behavior are common among patients with bipolar disorder. The relation between them and their impact on disease severity should be a focus of attention. This study aimed at assessment of the presence of sexual and religious obsessions in patients with bipolar disorder and their relation to suicide ideation.
Methods
Ninety patients diagnosed with bipolar I disorder were recruited consecutively and subdivided into two groups: bipolar disorder with and without sexual/religious obsessions. Both groups were subjected to Dimensional Yale‐Brown Obsessive–Compulsive Scale (DY‐BOCS), Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HAMD), and Beck Scale for Suicide Ideation (BSSI).
Results
Patients with bipolar disorder and sexual/religious obsessions were 54.4% (n = 49) of the total sample, and they showed significantly higher number of suicidal attempts, more severe depression, and suicidal ideation than those without sexual/religious obsessions. BSSI showed significantly positive correlation with HAMD and DY‐BOCS sexual and religious obsessions dimension‐related distress.
Conclusion
Sexual and religious obsessions tend to be more frequent among patients with bipolar disorder. Higher depression and obsessive‐related distress potentially contribute to the increased risk of suicidal ideation.