Department of Psychiatry, Bati Bahat Hospital, Istanbul, Turkey.
Compr Psychiatry. 2010 May-Jun;51(3):293-7. doi: 10.1016/j.comppsych.2009.07.006. Epub 2009 Aug 28.
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.
本研究旨在确定强迫症(OCD)共病的患病率,并评估 OCD 共病对双相障碍(BD)患者的社会人口学和临床特征的影响。
使用耶鲁-布朗强迫症量表症状清单和精神障碍诊断与统计手册第四版-IV/临床版对双相患者进行访谈,形成了 2 组,BD 伴 OCD 共病(BD-OCD)和 BD 不伴 OCD 共病。比较这些组的社会人口学和临床变量。
在 214 名 BD 患者中,21.9%的患者存在强迫观念和/或强迫行为,16.3%的患者存在 OCD 症状。虽然 BD-I(22/185,11.9%)和 BD-II(3/13,23.1%)患者的共患 OCD 频率无统计学差异,但 BD 未特指(10/16,62.5%)患者的 OCD 发生率明显高于 BD-I(P<.001)和 BD-II(P=0.03)。BD-OCD 组中有 6 名患者(17.1%)有慢性病程(至少有 1 次躁狂或抑郁发作,持续时间超过 2 年),而 BD 无 OCD 组则没有,这具有统计学意义。BD-OCD 组和 BD 无 OCD 组在年龄、性别、教育程度、婚姻状况、极性、BD 发病年龄、精神病性症状、快速循环、自杀企图史、首发类型和主要发作类型等方面均无统计学差异。
本研究的主要局限性在于一些变量的评估是基于回顾性回忆。
本研究证实了 OCD 在 BD 患者中的高共病率。未来使用纵向设计研究 OCD 和 BD 之间关系的研究可能有助于提高我们对这种关联机制的理解。