Bipolar Disorders Program and INCT Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, 90035-003 Porto Alegre, Brazil.
Compr Psychiatry. 2010 Jul-Aug;51(4):353-6. doi: 10.1016/j.comppsych.2009.11.001. Epub 2009 Dec 21.
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.
广泛性焦虑障碍在双相情感障碍中较为常见且危害性大。然而，人们对于强迫症共病是否会带来特殊影响知之甚少。本报告旨在评估在一个相对较大的双相情感障碍临床样本中，强迫症共病的患病率及其影响，同时将其他终生焦虑共病作为更严格的对照组。
这是一项连续临床样本的横断面研究，从摄入的《精神障碍诊断与统计手册》第四版结构化临床访谈中得出焦虑共病。采用汉密尔顿焦虑量表评估焦虑，采用 Young 躁狂评定量表和汉密尔顿抑郁评定量表评估（轻）躁狂和抑郁症状。采用世界卫生组织生活质量量表简表的各个领域评估生活质量。
终生强迫症共病的患病率为 12.4%。在躁狂期间未发现强迫症病例。与无焦虑共病的受试者相比，有强迫症病史的患者更有可能有自杀未遂、快速循环和酒精依赖的病史。强迫症患者在 WHOQOL 的所有领域的得分都较低。与其他有终生焦虑障碍的患者相比，强迫症患者的焦虑程度更高，这导致其 WHOQOL 社会领域的评分较低。
患有强迫症共病的双相情感障碍患者存在多种更为严重疾病的指标。更多的焦虑症状和较低的社会生活质量可能是双相情感障碍-强迫症共病的更为特异的特征。
