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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)

Published online by Cambridge University Press:  27 May 2019

Bernardo Dell’Osso*
Affiliation:
Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Milan, Italy Department of Psychiatry and Behavioral Sciences, Bipolar Disorders Clinic, Stanford University, Stanford, CA, USA “Aldo Ravelli” Center for Neurotechnology and Brain Therapeutic, University of Milan, Milan, Italy
Matteo Vismara
Affiliation:
Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Milan, Italy
Beatrice Benatti
Affiliation:
Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Milan, Italy
Giovanna Cirnigliaro
Affiliation:
Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Milan, Italy
Benedetta Grancini
Affiliation:
Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Milan, Italy
Naomi A. Fineberg
Affiliation:
Mental Health Unit, Hertfordshire Partnership Foundation Trust, QueenElizabeth II Hospital, Welwyn Garden City, UK
Michael Van Ameringen
Affiliation:
Department of Psychiatry and Behavioural Neurosciences, McMaster University, MacAnxiety Research Center, Hamilton, Canada
Eric Hollander
Affiliation:
Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine and Montefiore Medical Center, New York, NY, USA
Dan J. Stein
Affiliation:
MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
Josè M. Menchon
Affiliation:
Department of Psychiatry, Bellvitge University Hospital-IDIBELL, University of Barcelona, Cibersam, Barcelona, Spain
Carolyn I. Rodriguez
Affiliation:
Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
Humberto Nicolini
Affiliation:
Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Instituto Nacional de Medicina Genómica, Ciudad de México, Mexico
Nuria Lanzagorta
Affiliation:
Department of Clinical Research, Grupo Médico Carracci, Ciudad de México, México
Stefano Pallanti
Affiliation:
Department of Psychiatry, University of Florence, and Institute of Neurosciences, Florence, Italy
Giacomo Grassi
Affiliation:
Department of Psychiatry, University of Florence, and Institute of Neurosciences, Florence, Italy
Christine Lochner
Affiliation:
MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry, University of Stellenbosch, Stellenbosch, South Africa
Donatella Marazziti
Affiliation:
Dipartimento di Medicina Clinica e Sperimentale, Sezione di Psichiatria, Università di Pisa, Pisa, Italy
Georgi Hranov
Affiliation:
University Multiprofile Hospital for Active Treatment in Neurology and Psychiatry Sveti Naum, Sofia, Bulgaria
Oguz Karamustafalioglu
Affiliation:
Department of Psychiatry, Sisli Eftal Teaching and Research Hospital, Istanbul, Turkey
Luchezar Hranov
Affiliation:
University Multiprofile Hospital for Active Treatment in Neurology and Psychiatry Sveti Naum, Sofia, Bulgaria
Joseph Zohar
Affiliation:
Department of Psychiatry, Chaim Sheba Medical Center, Tel Hashomer, Israel
*
* Address correspondence to: Bernardo Dell’Osso, Department of Psychiatry, Department of Biomedical and Clinical Sciences “Luigi Sacco”, Director Psychiatry Unit 2, ASST Sacco-Fatebenefratelli, Via G.B. Grassi, 74, Milan20157, Italy. (Email: bernardo.dellosso@unimi.it)

Abstract

Introduction.

Bipolar disorder (BD) and obsessive compulsive disorder (OCD) are prevalent, comorbid, and disabling conditions, often characterized by early onset and chronic course. When comorbid, OCD and BD can determine a more pernicious course of illness, posing therapeutic challenges for clinicians. Available reports on prevalence and clinical characteristics of comorbidity between BD and OCD showed mixed results, likely depending on the primary diagnosis of analyzed samples.

Methods.

We assessed prevalence and clinical characteristics of BD comorbidity in a large international sample of patients with primary OCD (n = 401), through the International College of Obsessive–Compulsive Spectrum Disorders (ICOCS) snapshot database, by comparing OCD subjects with vs without BD comorbidity.

Results.

Among primary OCD patients, 6.2% showed comorbidity with BD. OCD patients with vs without BD comorbidity more frequently had a previous hospitalization (p < 0.001) and current augmentation therapies (p < 0.001). They also showed greater severity of OCD (p < 0.001), as measured by the Yale–Brown Obsessive Compulsive Scale (Y-BOCS).

Conclusion.

These findings from a large international sample indicate that approximately 1 out of 16 patients with primary OCD may additionally have BD comorbidity along with other specific clinical characteristics, including more frequent previous hospitalizations, more complex therapeutic regimens, and a greater severity of OCD. Prospective international studies are needed to confirm our findings.

Type
Original Research
Copyright
© Cambridge University Press 2019

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