Pattern of Obsessive Compulsive Symptoms among Patients with Bipolar-I Disorder

Abstract

Background: Clinicians have observed the occurrence of obsessive and/or compulsive symptoms within the course of bipolar disorder. However the pattern of their occurrence is not clearly delineated. This study aimed to explore this pattern.Method: A cross sectional study. All patients were assessed by the Structured Clinical Interview for DSM-IV (SCID I) to diagnose bipolar disorder (BD) and comorbid obsessive compulsive (OC) symptoms. The symptom severity was assessed by Young Mania Rating Scale (YMRS), Beck Depression Inventory II (BDI-II), Yale-Brown Obsessions and compulsions Scale (Y-BOCS).Results: Sixty two patients were classified into two groups: BD comorbid with OC symptoms (BD-OC) and BD with no comorbidity (BD). High rates of OC symptoms in BD patients (38.7%) with higher educational level in the BD-OC group, and higher rates of unemployment were noticed among patients of BD-OC group. The smoking was more prevalent in BD group than BD-OC group. The most common among BD-OC subjects were contamination, religious and aggressive obsessions and cleaning/washing and counting compulsions. Limitations:The prevalence rates are not to be generalized because of the small size of the sample. Most of the history was taken from the patients and their relatives depending on their memory. More experimental study designs about the effectiveness of different types of management strategies would be beneficial to the patients. Conclusion: Bipolar Patients with comorbid Obsessive and/orCompulsive symptoms showed higher educational levels, unemployment, greater functional impairment, and less smoking. Most common obsessions were contamination, religious and aggressive obsessions, cleaning and counting compulsions. bipolar and OCD and those with just OCD. Those with pure OCD have more checking compulsions while those with comorbidity exhibit more obsessions that are classified as "others" which they described as "existential, philosophical, and/or superstitious". In general they found that although the amount of obsessions were equal whether comorbid or not, those who also had bipolar disorder actually had fewer compulsions [13].Those with comorbid bipolar disorder and obsessive-compulsive disorder typically experience heightened feelings of distress over those with only one of the disorders. This is not unique to comorbid OCD and bipolar disorder; comorbidity in general is typically reflected by increased levels of distress and increased treatment [18]. For those with comorbid OCD and bipolar disorder, there is also an increased risk for alcohol and substance abuse [19].A group of researchers has looked at how OCD and bipolar relate. They found that whereas unipolar depression was "incidental", i.e. not clearly related to the OCD (although common) by contrast bipolar disorder seemed to be more directly related to the OCD. For example, people with religious and sexual obsessions as part of their OCD were more likely than those with other obsessions to have bipolar disorder. The authors specifically recommend that bip...

Insights on the Anxiety Disorders

“…This study employed a cross sectional study on selected patients to diagnose bipolar disorder (BD) and comorbid obsessive compulsive (OC) symptoms. Investigations of the study found that underlined symptoms were observed in case of unemployment, greater functional impairment, and less smoking and most common obsessions were contamination, religious and aggressive obsessions, cleaning and counting compulsions [1].…”