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

Abstract

Introduction Comorbid obsessive-compulsive disorder (OCD) is common in bipolar disorder (BD). Clinical characteristics, functionality and familial pattern of this comorbidity are largely understudied. Objective To assess clinical profile, familial loading of psychiatric disorders and level of functioning in remitted BD patients who have comorbid OCD and to compare results with those of remitted BD patients without OCD. Methods Remitted BD-I subjects were assessed using the Structured Clinical Interview for DSM-IV Axis I Disorders, Global Assessment of Functioning Scale (GAF), Hamilton Depression Rating Scale (HDRS), Young Mania Rating Scale (YMRS), Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and Family Interview for Genetic Studies (FIGS). BD patients with and without OCD were compared. Group differences were analyzed using the chi-square test and the independent samples t test. Values <0.05 were considered statistically significant. Results Of the 90 remitted BD-I patients, 35.5% (n=32) had obsessive-compulsive symptoms/OCD. The BD-OCD group showed significantly lower GAF scores, higher rates of suicidal attempts, hospitalizations, manic and depressive episodes compared to the group with BD only (p<0.05). In addition, first and second-degree relatives had higher rates of BD-OCD and OCD, but not of BD. Conclusions BD-OCD is characterized by more severe BD, more dysfunction and higher familial loading of BD-OCD and OCD. Larger studies involving relatives of probands will help to confirm our findings and to delineate nosological status of BD-OCD comorbidity.

Lifetime bipolar disorder comorbidity and related clinical characteristics in patients with primary obsessive compulsive disorder: a report from the International College of Obsessive–Compulsive Spectrum Disorders (ICOCS)

“…In this respect, previous international reports showed a higher rate of other comorbid DSM-IV-TR Axis I disorders, compared with BD, with major depressive disorder and anxiety disorders being the most common comorbid conditions in primary OCD patients. 1,24 The higher rate of previous hospitalization in the comorbid cases seems to be consistent with previous reports 4,17,19,25,26 and may likely be determined by the co-occurrence of BD episodes, causing more frequent admission to hospital (following severe manic or depressive episodes), even though it may also be related to OCD worsening due to a higher severity of OCD in comorbid patients (as suggested by the greater severity of illness confirmed by the Y-BOCS in these individuals).…”

Suicide Risk in Comorbid Bipolar Disorder and Obsessive-Compulsive Disorder: A Systematic Review

“…More than 80% of the selected studies presented higher rates of history of suicide attempts and lifetime depressive episodes in BD-OCD patients compared to non-comorbid patients. [13][14][15][16][17] In the Epidemiologic Catchment Area (ECA) database, BD-OCD patients had statistically significant higher lifetime rates of "thoughts of suicide," "thoughts of death," "suicide attempts," and "wanting to die" versus non-comorbid patients. [18] These features were also confirmed in a case-control study conducted in the USA in the adolescent population.…”

“…et al [14] n 23/31 et al [21] n 20/31 et al 2000 [15] n 22/31 et al [16] n 23/31 et al [22] n 23/31…”

Comorbidade entre transtorno bipolar e transtorno obsessivo-compulsivo: aspectos epidemiológicos, clínicos e terapêuticos.

“…Por outro lado, estudo com 90 sujeitos com TB não encontrou diferença na idade média de início dos sintomas comparando os grupos com TOC e sem TOC (23.38±7.23 anos vs 24.74±8.39 anos, respectivamente; p=0.44) [10]. Semelhantemente, estudo realizado na Turquia, com 214 pacientes com TB (com TOC comórbido e sem TOC comórbido) não encontrou diferença na idade média de início dos sintomas de humor entre os dois grupos [11].…”