title: Obsessive-compulsive disorder with and without bipolar disorder.
abstract: OBJECTIVE
  Bipolar disorder (BD) is often comorbid with obsessive-compulsive disorder (OCD). In this study, we compared clinical profile and course of subjects with a primary diagnosis of OCD with and without BD.
  
  
  METHODS
  We compared 34 subjects with primary diagnosis of OCD with BD and 57 subjects with a diagnosis of OCD without BD. Structured interview schedules, clinical rating scales, and information from clinical charts were utilized to assess patients.
  
  
  RESULTS
  OCD with BD was characterized by: (i) an episodic course; (ii) a higher number of depressive episodes, greater suicidality and a higher rate of hospitalization; (iii) fewer pathological doubts and more miscellaneous compulsions; and (iv) poorer insight into obsessive-compulsive symptoms.
  
  
  CONCLUSIONS
  Episodic course appears to be typical of OCD with BD. Bipolarity has a pathoplastic effect on OCD and it is possible that some forms of OCD and BD are pathophysiologically related. Bipolar OCD is associated with a higher rate of depressive episodes, higher suicidality and more frequent hospitalizations, suggesting greater morbidity. Long-term prospective follow-up studies and studies addressing pathophysiology and genetic basis are needed to understand the complexity of such comorbidity.
authors.affiliation: Sunshine Hospital, Mid West Area Mental Health Service, Melbourne, Australia.
authors.forename: Rajnarayan
authors.initials: R
authors.lastname: Mahasuar
authors.forename: Y C
authors.initials: YC
authors.lastname: Janardhan Reddy
authors.forename: Suresh Bada
authors.initials: SB
authors.lastname: Math
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D018450:Disease Progression; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D019545:Intuition; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D059020:Suicidal Ideation