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Depress Anxiety. 2012 Mar;29(3):226-33. doi: 10.1002/da.20908. Epub 2011 Nov 22.

Phenomenological features and clinical impact of affective disorders in OCD: a focus on the bipolar disorder and OCD connection.

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  • 1University of Miami, Coral Gables, Florida 33146, USA. kiaratimpano@gmail.com

Abstract

BACKGROUND:

Given the general population prevalence rates of obsessive compulsive disorder (OCD) and the affective disorders, one would expect the co-occurrence of these syndromes to be rare. Yet findings by our group and others have revealed extremely high rates of comorbidity in OCD with both depressive disorders (DD; 50%) and bipolar disorder (BPD; 10%). The current investigation sought to further clarify the role affective disorder comorbidity-particularly that with BPD-may play in the clinical expression of OCD.

METHOD:

A total of 605 individuals with OCD were evaluated with the Structured Clinical Interview for DSM-IV. The sample included three groups: BPD (bipolar I or II; N = 79, 13.1%), DD (major depression or dysthymia; N = 388, 64.1%), and NAD (no affective disorder comorbidity; N = 138, 22.8%). Group-wise comparisons were conducted on comorbidity patterns, impairment measures, and clinical features of OCD.

RESULTS:

Analyses revealed a graded severity pattern, with the BPD group as the most severe, followed by the DD group, and finally the NAD group. Severity was reflected by the total number of Axis I disorders (P<.01), the number of psychiatric hospitalizations (P<.001), impairment measures (Ps<.05), and OCD symptoms (P<.01). It is worth noting that the impairment and OCD symptom severity findings were not attributable to the higher level of nonmood disorder comorbidities in the BPD and DD groups.

RESULTS:

Those individuals with comorbid affective disorders, particularly BPD, represent a clinically severe group compared to those without such comorbidity. Clarifying the phenomenological features of OCD-affective disorder comorbidity has important etiological and treatment implications.

© 2011 Wiley Periodicals, Inc.

PMID:
22109969
[PubMed - indexed for MEDLINE]
PMCID:
PMC3322278
Free PMC Article
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