Discuss Bipolar
Blog to discuss being Bipolar
Patients with bipolar disorder and comorbid
obsessive-compulsive disorder (OCD) are more likely to have a
history of suicide attempts, rapid cycling, and alcohol dependence
compared with their peers without anxiety comorbidities, study
results show.
“The data in this report support the notion that comorbid OCD is
fairly common, is associated with disease severity, and has
important consequences regarding symptom- and patient-rated
outcomes,” comment Flávio Kapczinski (Hospital de
Clínicas de Porto Alegre, Brazil) and colleagues.
The prominence of anxiety in general and OCD in particular among
patients with bipolar disorder has long been acknowledged. Recent
studies have tried to investigate the illness burden of OCD, but
comparisons have usually been made between those with and without
OCD comorbidity.
“This is little informative because those patients with any
comorbidity tend to differ in a number of measures from those with
‘pure’ bipolar disorder,” the researchers explain in the journal
Comprehensive Psychiatry.
To address this, they performed a cross-sectional study of
lifetime comorbidities in 259 patients with bipolar disorder, using
anxiety comorbidities as a “more rigorous control group with the
aim of uncovering more specific correlates of OCD comorbidity in
bipolar disorder.”
Kapczinski et al report that lifetime prevalence of any
anxiety disorder was 55.6%, and of OCD, 12.4%. Current prevalence
of OCD was 8.5%; although no cases were detected during mania, it
was diagnosed in 8.4% of those in a euthymic phase, 13.9% of those
depressed, and 13.0% of those with mixed episodes.
The researchers note that this fits with recent studies showing
that obsessions or compulsions may remit during mania to reappear
in depression.
Compared with patients with no anxiety comorbidity, those with
lifetime OCD were more likely to be women (61.8% vs 84.4%), to have
a longer period of untreated illness (8 vs 13 years), have a
lifetime history of suicide attempts (35% vs 70%), rapid cycling
(14% vs 39%), and alcohol dependence (10% vs 31%).
Patients with OCD also had higher depression and anxiety symptom
scores than those without anxiety comorbidity, but fewer manic
symptoms.
Meanwhile, when compared with patients with other lifetime
anxiety disorders, those with OCD comorbidity had a lower quality
of life on the social domain.
Kapczinski et al comment: “Patients with OCD are troubled
by thoughts and behaviors, which seem frequently repugnant and
further restrict their social functioning.
“They also often incite friends or family members to engage in
their illness-related behaviors, which may result in conflict.”
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2010
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