Caratteristiche sociodemografiche e cliniche del disturbo ossessivo-compulsivo in comorbilità con il disturbo bipolare

Abstract

Introduction

The onset of bipolar symptoms in patients with obsessive-compulsive disorders (OCD) is a common problem with important prognostic and therapeutic implications. Rates of comorbidity between the two disorders run as high as 30%. The aim of the present study was to explore socio-demographic and clinical differences between OCD patients with and without bipolar disorders to identify predictive factors that can guide treatment choices.

Materials and methods

The sample included 290 adult patients with primary OCD (Yale-Brown Obsessive-Compulsive scores of ≥ 16) diagnosed according to DSM-IV criteria: 259 with pure OCD and 31 with OCD and bipolar disorders. All provided informed consent. Validated, semi-structured interviews were used to collect socio-demographic and clinical data.

Results

Compared with the pure OCD group, the OCD-bipolar group was characterized by a higher prevalence of males (83.8% vs 50.6%), significant family history of mood disorders (51.6% vs. 23.9%), and higher frequencies of sexual (41.9% vs. 18.5%) and hoarding (29.0% vs. 13.1%) obsessions and repetition (64.5% vs. 45.2%) and hoarding (25.8% vs. 12.0%) compulsions. In addition, OCD with bipolar disorder was significantly associated with substance use disorders (19.4% vs. 5.0%) and, with reference to Axis II comorbidity, obsessive-compulsive personality disorder (22.5% vs. 10.4%).

Conclusions

Our findings reveal specific differences between subjects with OCD with and without comorbid bipolar disorder. They suggest that there may be identifiable subgroups of patients with OCD whose disease has specific features and different etiopathogenetic bases for which targeted therapeutic approaches are needed.