The Mediating Role of Sleep Disturbances in the Relationship Between Obsessive-Compulsive Symptoms and Suicidal Ideation: The Moderating Effect of Childhood Trauma

Objective: This study aims to investigate the relationships and underlying mechanisms among obsessive-compulsive symptoms, sleep disturbances, childhood trauma, and suicidal ideation in patients with obsessive-compulsive disorder (OCD). Methods: The study employed the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Pittsburgh Sleep Quality Index (PSQI), Childhood Trauma Questionnaire (CTQ), and a self-assessment scale for suicidal ideation (SIOSS) to survey 107 patients with OCD. Results: Obsessive-compulsive symptoms significantly positively affected sleep quality (β = 0.31, t = 10.67, p < 0.001). Both sleep disturbances (β = 0.20, t = 7.86, p < 0.001) and obsessive-compulsive symptoms (β = 0.39, t = 14.65, p < 0.001) significantly predicted suicidal risk. Further analysis revealed that sleep disturbances served as a significant mediator between obsessive-compulsive symptoms and suicidal ideation (mediation effect value = 0.08, 95% CI = [0.22, 0.28]). Childhood trauma moderated the mediating effect, intensifying the positive impact of obsessive-compulsive symptoms on sleep disturbances and suicidal ideation as levels of childhood trauma increased. Conclusion: Sleep disturbances mediate the relationship between obsessive-compulsive symptoms and suicidal ideation, with this mediation significantly influenced by the presence of childhood trauma. These findings underscore the importance of considering early life experiences and psychophysiological backgrounds when assessing and intervening in the suicidal risk of OCD patients.