Correlates and impact of obsessive-compulsive comorbidity in bipolar disorder.

Anxiety morbidity in general is frequent and harmful in bipolar disorder. Little is known, however, whether obsessive-compulsive comorbidity entails particular effects. This report aims to evaluate the prevalence and impact of obsessive-compulsive disorder (OCD) comorbidity in a relatively large clinical sample of bipolar disorder, with other lifetime anxiety comorbidities used as a more rigorous control group. A cross-sectional study in a consecutive clinical sample, with anxiety comorbidity derived from the intake Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, was conducted. Anxiety was assessed with the Hamilton Anxiety Rating Scale. The Young Mania Rating Scale and the Hamilton Depression Rating Scale were used to assess (hypo)manic and depressive symptoms. The domains of the WHOQOL BREF were used to evaluate quality of life. Lifetime prevalence of OCD comorbidity was 12.4%. No cases of OCD were detected during mania. Compared with subjects with no anxiety comorbidity, those with lifetime OCD were more likely to have a history of suicide attempts, rapid cycling, and alcohol dependence. Patients with OCD had a lower score on all domains of the WHOQOL. Compared with those with other lifetime anxiety disorders, those with OCD had more anxiety, which mediated a lower WHOQOL social domain. Bipolar disorder patients with obsessive-compulsive comorbidity have a number of indicators of an overall more severe illness. The presence of more anxiety symptoms and a lower social quality of life may be more specific features of the bipolar-OCD comorbidity.

Magalhães PV ，Kapczinski NS ，Kapczinski F 《-》

Bipolar obsessive-compulsive disorder and personality disorders.

Maina G ，Albert U ，Pessina E ，Bogetto F ... -  《BIPOLAR DISORDERS》

Impact of obsessive-compulsive disorder comorbidity on the sociodemographic and clinical features of patients with bipolar disorder.

In this study, our aim is to determine the prevalence rates of obsessive-compulsive disorder (OCD) comorbidity and to assess the impact of OCD comorbidity on the sociodemographic and clinical features of patients with bipolar disorder (BD). Using the Yale-Brown Obsessive Compulsive Scale Symptom Checklist and Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-IV/Clinical Version on bipolar patients, 2 groups, BD with OCD comorbidity (BD-OCD) and BD without OCD comorbidity, were formed. These groups were compared for sociodemographic and clinical variables. Of 214 patients with BD, 21.9% of them had obsession and/or compulsion symptoms and 16.3% had symptoms at the OCD level. Although there was no statistically significant difference between the frequency of comorbid OCD in BD-I (22/185, 11.9%) and BD-II (3/13, 23.1%) patients, but OCD was found to be significantly high in BD not otherwise specified (10/16, %62.5) patients than BD-I (P < .001) and BD-II (P = .03). Six patients (17.1%) of the BD-OCD group had chronic course (the presence of at least 1 mood disorder episode with a duration of longer than 2 years), whereas the BD without OCD group had none, which was statistically significant. There were no statistically significant differences between BD-OCD and BD without OCD groups in terms of age, sex, education, marital status, polarity, age of BD onset, presence of psychotic symptoms, presence of rapid cycling, history of suicide attempts, first episode type, and predominant episode type. Main limitation of our study was the assessment of some variables based on retrospective recall. Our study confirms the high comorbidity rates for OCD in BD patients. Future studies that examine the relationship between OCD and BD using a longitudinal design may be helpful in improving our understanding of the mechanism of this association.

Koyuncu A ，Tükel R ，Ozyildirim I ，Meteris H ，Yazici O ... -  《-》

Obsessive-compulsive disorder in bipolar disorder patients with first manic episode.

Pashinian A ，Faragian S ，Levi A ，Yeghiyan M ，Gasparyan K ，Weizman R ，Weizman A ，Fuchs C ，Poyurovsky M ... -  《JOURNAL OF AFFECTIVE DISORDERS》

The effect of anxiety disorder comorbidity on treatment resistant bipolar disorders.

High rates of anxiety disorders have been reported in bipolar disorders. We undertook this study to determine the impact of anxiety disorders on bipolar disorders in our tertiary care referral center. We reviewed the literature on this topic and also reviewed records of 44 treatment resistant bipolar patients evaluated by DLD at the Center for Anxiety and Depression. Twenty-three patients had comorbid panic disorder, posttraumatic stress disorder, or obsessive-compulsive disorder. We compared bipolar patients with and without a history of comorbid anxiety disorders regarding several clinical factors, including mean age, percentage of women, mean age of onset, history of suicide attempts, history of rapid cycling, history of substance abuse, family history, and mean ratings for mood rating scales. Statistical differences were assessed by chi(2) and t-tests. On several measures, bipolar patients with comorbid anxiety disorders were more significantly ill than bipolar patients without comorbid anxiety disorders. For instance, patients with an anxiety disorder were more likely to have an earlier age of onset of illness, have higher (worse) ratings on the Hamilton Anxiety Rating Scale, 17-item Hamilton Depression Rating Scale, Montgomery and Asberg Depression Rating Scale, Beck Depression Inventory, and lower (more impaired) ratings on the Global Assessment of Functioning Scale. Comorbid anxiety disorders were also associated with a more frequent history of substance abuse and higher ratings for suicidal ideation. Anxiety disorders negatively impact the course of bipolar disorders. The high prevalence and risk rate of comorbid anxiety disorders in bipolar patients highlight the need for greater clinical attention to this population.

Lee JH ，Dunner DL 《DEPRESSION AND ANXIETY》