title: Obsessive-compulsive disorder in bipolar disorder patients with first manic episode.
abstract: BACKGROUND
  Evidence indicates that obsessive--compulsive disorder (OCD) co-occurs with schizophrenia and bipolar disorder (BD) at a higher rate than in the general population. The inflated rate of comorbidity may result from chronic illness, antipsychotic therapy or treatment-seeking behavior. To control for these factors we evaluated the prevalence of OCD in patients with first-episode acute mania who met DSM-IV criteria for BD-I, and compared them with our previously reported group of first-episode schizophrenia patients.
  
  
  METHODS
  Fifty-six BD-I patients with a first-episode of acute mania were screened for OCD and additional comorbid disorders using the Structured Clinical Interview for DSM-IV Axis-I disorders and appropriate rating scales.
  
  
  RESULTS
  Only one patient (1.8%) met DSM-IV criteria for OCD, and two (3.6%) met criteria for sub-threshold OCD. In contrast, there was a substantial aggregation of substance use disorders 32.1% (N=8), anxiety disorders, other than OCD 26.8% (N=15) and eating disorders 14.3% (N=8).
  
  
  CONCLUSIONS
  Small sample size, cross-sectional nature of the assessments and the inclusion of only BD-I patients.
  
  
  CONCLUSIONS
  The rate of OCD in first-episode BD-I patients did not differ significantly from that found in the general population and was substantially lower than in previously reported first-episode schizophrenia patients (1.8% vs. 14%). We suggest that a preferential association of OCD with schizophrenia early in the course of illness represents a pathophysiological linkage between the two disorders, and putatively a specific schizo-obsessive subtype. In contrast, OCD in BD-I may stand for "true" comorbidity. Large-scale parallel comparative evaluations of comorbidity in BD-I and schizophrenia may contribute to the search for specific pathophysiological mechanisms of distinct comorbid-related subsets in either disorder.
authors.affiliation: Research Unit, Tirat Carmel Mental Health Center, Tirat Carmel, Israel.
authors.forename: Artashez
authors.initials: A
authors.lastname: Pashinian
authors.forename: Sarit
authors.initials: S
authors.lastname: Faragian
authors.forename: Aya
authors.initials: A
authors.lastname: Levi
authors.forename: Maruke
authors.initials: M
authors.lastname: Yeghiyan
authors.forename: Khachatur
authors.initials: K
authors.lastname: Gasparyan
authors.forename: Ronit
authors.initials: R
authors.lastname: Weizman
authors.forename: Abraham
authors.initials: A
authors.lastname: Weizman
authors.forename: Camil
authors.initials: C
authors.lastname: Fuchs
authors.forename: Michael
authors.initials: M
authors.lastname: Poyurovsky
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D001068:Feeding and Eating Disorders / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology; D013223:Statistics as Topic; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology