Comorbid obsessive compulsive disorder in patients with bipolar-I disorder.

Limited numbers of studies have examined the prevalence of OCD systematically in consecutively sampled adult bipolar disorder type I (BD-I) patients. We examined the frequency of OCD in a large number (n=396) of consecutively hospitalized patients with BD-I and identified socio-demographic and clinical correlates of BD-I with and without OCD. BD-I patients (n=396) were assessed using the Mini International Neuropsychiatric Interview for Bipolar Disorder Studies, the Structured clinical interview for (Axis II) DSM-IV, the Family interview for genetic studies, the Yale-Brown Obsessive-Compulsive Scale, the Young Mania Rating Scale, the Hamilton Rating Scale for Depression, the Global Assessment of Functioning (GAF) and the Clinical Global Impression scale. Patients with and without OCD were compared in terms of various socio-demographic and clinical variables. Thirty (7.6%) of the 396 inpatients studied had OCD and 15 (3.8%) had subclinical OCD. BD-OCD group had significantly lower GAF scores, higher rates of unemployment, and lower incidence of psychotic symptoms. In addition, BD-OCD group had higher rates of comorbid social anxiety and anxious avoidant personality disorder (AAPD) and OCD in first-degree relatives. Those with clinical and subclinical OCD did not differ on functioning and severity measures. Retrospective design and recruitment of patients from inpatient services of a tertiary psychiatric hospital. OCD is not an uncommon comorbid disorder in BD-I and appears to be associated with greater functional disability. BD-I with comorbid OCD is associated with greater family history of OCD, comorbidities of social phobia and AAPD and less of psychotic symptoms.

Shashidhara M ，Sushma BR ，Viswanath B ，Math SB ，Janardhan Reddy YC ... -  《-》

Clinical and familial profile of bipolar disorder with and without obsessive-compulsive disorder: an Indian study.

Kazhungil F ，Cholakottil A ，Kattukulathil S ，Kottelassal A ，Vazhakalayil R ... -  《-》

Bipolar obsessive-compulsive disorder and personality disorders.

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

Bipolar disorder comorbidity in patients with obsessive-compulsive disorder: Prevalence and predictors.

Patients with obsessive-compulsive disorder (OCD) often present with comorbidities, mainly anxiety and affective disorders, which may influence OCD course, help-seeking and treatment response. Some authors have studied bipolar disorder (BD) comorbidity in patients with OCD, but usually in small samples. The objective was to estimate the lifetime prevalence of BD in a large clinical sample of OCD patients, and to compare demographic and clinical features of patients with and without BD comorbidity. This cross-sectional study with 955 adult OCD patients from the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders (C-TOC) used several assessment instruments, including the Yale-Brown Obsessive-Compulsive Scale, the Dimensional Yale-Brown Obsessive-Compulsive Scale, the Beck Depression and Anxiety Inventories, and the Structured Clinical Interview for DSM-IV Axis I Disorders. Descriptive and bivariate analyses were followed by logistic regression. The lifetime prevalence of BD was 7.75% (N = 74). The variables that were independently associated with BD comorbidity were: panic disorder with agoraphobia, impulse control disorders, and suicide attempts. The cross-sectional design does not permit causal inferences; the external validity may be limited, as the participants were from tertiary services. Despite the large sample size, some analyses may have been underpowered due to the relatively low prevalence of the outcome and of some explanatory variables. Patients with OCD comorbid with BD have some clinical features indicative of greater severity, including higher suicide risk, and require a careful therapeutic approach for the appropriate treatment of both disorders.

Domingues-Castro MS ，Torresan RC ，Shavitt RG ，Fontenelle LF ，Ferrão YA ，Rosário MC ，Torres AR ... -  《-》

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 ... -  《-》