The specific pattern of obsessive-compulsive symptoms in patients with bipolar disorder

Abstract

• BACKGROUND: Some preliminary findings have suggested that patients with bipolar disorder show a disparate pattern of obsessive-compulsive (OC) symptoms. This study aimed to reevaluate this subject on a different sample within a different cultural background.
• METHODS: The present cross-sectional study was carried out in a clinical non-experimental setting on 78 obsessivecompulsive disorder (OCD) patients; 39 with and 39 without bipolar disorder (BD). Subjects underwent a Structured Clinical Diagnostic Interview for DSM-IV (SCID-I) as well as the Yale-Brown Obsessive-Compulsive Rating Scale (YBOCS).
• RESULTS: The diagnoses in the non-bipolar group were mostly major depressive disorder (38%) and dysthymic disorder (38%). The mean age of the bipolar group was significantly lower than that of the non-bipolars (P < 0.05). The mean score of the Y-BOCS was not significantly different between the two groups. The mean estimated number of obsessive themes – but not compulsive ones – in the bipolar group was significantly higher than that of the non-bipolars (P < 0.0001). The aggressive (P < 0.01), sexual (P < 0.0001) and religious (P < 0.05) obsessions were significantly more prevalent, and the contamination obsession (P < 0.05) was significantly less prevalent in the bipolar group. Also, in the bipolar group the miscellaneous compulsions (P < 0.01) were significantly more prevalent, and the washing compulsion (P < 0.001) was significantly less prevalent.
• CONCLUSIONS: The content of OC symptoms which is not traditionally considered a helpful factor for diagnosing a psychiatric disorder might be able to lead the clinician to the diagnosis of bipolarity in a depressed patient with OCD.
• KEY WORDS: Bipolar disorder, obsessive-compulsive disorder, obsessive-compulsive symptoms.