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

ABSTRACT

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. The present cross-sectional study was carried out in a clinical non-experimental setting on 78 obsessive-compulsive 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 [Y-BOCS]. 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. 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