MedWire News: Patients with bipolar disorder and comorbid obsessive–compulsive disorder (OCD) appear to have a more chronic illness course, marked by protracted episodes of depression, compared with bipolar disorder patients with no such comorbidity.
Since OCD on its own tends to follow a chronic course, the results suggest that OCD could impart an “alternative expression” on bipolar disorder or that the two disorders “may be part of the same shared diathesis,” say Ilker Özyildirim (Ünye State Hospital, Ordu, Turkey) and colleagues.
A spate of recent studies has addressed the issue of comorbid anxiety disorders in patients with bipolar disorder, focusing mostly on prevalence rates.
“In this study, our aim was to evaluate how comorbid OCD affects the sociodemographic and clinical features of bipolar patients in particular,” the researchers explain in the journal Comprehensive Psychiatry.
They recruited 214 bipolar disorder patients, of whom 185 had bipolar I disorder, 13 had bipolar II disorder, and the remaining 16 had bipolar disorder not otherwise specified (NOS).
In all, 21.9% of the patients had obsessive and/or compulsive symptoms and 16.3% had OCD.
Among the bipolar disorder–OCD group, 22 (11.9%) patients had bipolar I disorder, three (23.1%) had bipolar II disorder, and 10 (62.5%) patients had bipolar disorder NOS.
There were no statistically significant differences between comorbid and non-comorbid groups in terms of age, gender, education, marital status, polarity, age of bipolar disorder onset, presence of psychotic symptoms, presence of rapid cycling, history of suicide attempts, first episode type, or predominant episode type.
However, six (17.1%) patients in the comorbid group had a chronic course of illness (defined by the presence of at least one mood disorder episode lasting longer than 2 years; in this case depression), whereas the non-comorbid group had no such cases, a significant difference.
“Because bipolar disorder, which generally progresses episodically, tends to progress chronically in the presence of comorbid OCD, which itself predominantly progresses chronically, it is possible that there is a potential psychopathologic link between these disorders,” the researchers conclude.
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