title: Clinical outcome in patients with bipolar I disorder, obsessive compulsive disorder or both.
abstract: BACKGROUND
  Bipolar disorder (BPD) is often comorbid with obsessive-compulsive (OCD) and other anxiety disorders, but the impact of such comorbidity on long-term outcome has not been evaluated systematically.
  
  
  METHODS
  Extensive follow-up assessments were carried out at 4.3 years after index hospitalizations in a mixed BPD-OCD group (N=20) compared to matched groups with BPD (N=22) or OCD (N=20) alone.
  
  
  RESULTS
  At follow-up, ratings of functional status were similar across groups. Rehospitalizations were similar among BPD-OCD and BPD subjects, but 2.9-times more frequent among comorbid than OCD patients. OCD symptoms averaged 150% more severe in OCD than comorbid subjects, and were not measured in BPD subjects.
  
  
  CONCLUSIONS
  Despite potential sampling bias with previously hospitalized subjects, the findings suggest that comorbid BPD-OCD patients may be clinically more similar to BPD than OCD patients, and that BPD-OCD comorbidity may not negatively impact the long-term clinical outcome.
authors.affiliation: Schizophrenia and Bipolar Disorder Program, McLean Hospital, Belmont 02478, and Department of Psychiatry, Harvard Medical School, Cambridge, MA, USA. fcentorrino@mclean.harvard.edu
authors.forename: Franca
authors.initials: F
authors.lastname: Centorrino
authors.forename: John
authors.initials: J
authors.lastname: Hennen
authors.forename: Gopinath
authors.initials: G
authors.lastname: Mallya
authors.forename: Samy
authors.initials: S
authors.lastname: Egli
authors.forename: Tim
authors.initials: T
authors.lastname: Clark
authors.forename: Ross J
authors.initials: RJ
authors.lastname: Baldessarini
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000453:epidemiology* / Q000503:physiopathology; D017063:Outcome Assessment, Health Care; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index