{
  "abstract": "IntroductionDepression accounts for much of the association between obsessive-compulsive disorder and suicidal ideation in clinical samples, but whether other features carry independent information is unclear. We examined what non-depression features reveal about suicidal ideation.\n\nMethodsAdults with obsessive-compulsive disorder (N = 231) completed measures of quality of life, anxiety, physical symptoms, obsessive-compulsive symptoms and traits, and personality. Elastic net, random forest, and explainable boosting machines identified suicidal ideation (Beck Depression Inventory-II item 9) without depression measures in nested cross-validation. Secondary analyses compared these features with depression severity.\n\nResultsSixty-six participants (28.6%) endorsed suicidal ideation; 61 of these (92.4%) reported thoughts without intent to act. All models showed similar discrimination (area under the curve = .77-.78), as did depression severity alone (.77). Adding the features to depression severity yielded a small estimated gain (difference = .02, 95% confidence interval: -.03 to .06), and flexible models offered no reliable advantage. Most features, including trait anxiety and obsessive-compulsive symptom severity, were associated with suicidal ideation on their own, but these associations attenuated under mutual adjustment. Lower quality of life remained the clearest correlate.\n\nConclusionNon-depression features identified suicidal ideation about as well as depression severity, consistent with substantial shared, distress-related information. Clinicians should ask about suicidal ideation directly, whatever a patients depressive symptoms, and consider overall distress in case formulation.",
  "abstract_shown": true,
  "affiliations": [
    "Yale University"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "B. A. Zaboski"
    },
    {
      "name": "E. F. Mattera"
    },
    {
      "name": "C. A. Pittenger"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6p56398twjyts.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.05.31.26354549",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.05.31.26354549v2.full",
  "id": "6p56398twjyts",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.05.31.26354549v2",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "psychiatry and clinical psychology"
    ],
    [
      "openalex",
      "3203|Suicide and Self-Harm Studies"
    ]
  ],
  "openalex": "W7163338156",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.05.31.26354549v2.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-05-31",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/6p56398twjyts.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:43Z",
      "native_id": "10.64898/2026.05.31.26354549",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.05.31.26354549v2"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:psychiatry and clinical psychology",
      "subfield": "psychiatry"
    }
  ],
  "title": "Clinical Correlates of Suicidal Ideation in Adults With Obsessive-Compulsive Disorder: An Interpretable Machine Learning Study",
  "title_text": "Clinical Correlates of Suicidal Ideation in Adults With Obsessive-Compulsive Disorder: An Interpretable Machine Learning Study",
  "type": "preprint",
  "updated_at": "2026-10-30T12:19:43Z",
  "url": "https://research.draconitic.com/paper/6p56398twjyts",
  "venue": "medRxiv",
  "versions": []
}