title: Lifetime comorbidity of obsessive-compulsive disorder and sub-threshold obsessive-compulsive symptomatology in the community: impact, prevalence, socio-demographic and clinical characteristics.
abstract: OBJECTIVE
  This study aims to expand the available knowledge on Obsessive Compulsive Disorder (OCD)-comorbidity by investigating the prevalence and clinical impact on a group of individuals with OCD or subthreshold OC syndrome (OCS), prospectively followed-up over an extended period.
  
  
  METHODS
  A stratified sample of the general population of the canton of Zurich, Switzerland (n = 591), participated in a series of seven interviews over a 30-year period. Clinically significant comorbid subgroups of OCD/OCS were compared to cases of OCD/OCS without respective comorbidity, in order to determine differences in socio-demographic and other clinical characteristics.
  
  
  RESULTS
  Lifetime rates of psychiatric comorbidity were high and increased in prevalence across the OC severity spectrum. Bipolar affective disorder was significantly associated with OCD whereas unipolar major depression and both alcohol and drug misuse disorders were not. Most forms of comorbidity increased distress and impacted negatively on family and work relationships, though disorder-specific effects were observed. Thus, agoraphobia and GAD were associated with increased OCD-severity; bipolar disorder was associated with suicidal acts and panic disorder increased treatment-seeking behaviour.
  
  
  CONCLUSIONS
  Despite the statistical limitations imposed by the small sample-size, our findings highlight the negative impact of psychiatric comorbidity on health and psychosocial function.
authors: National Obsessive Compulsive Disorders Specialist Service, Hertfordshire Partnership NHS Foundation Trust, Queen Elizabeth II Hospital, Welwyn Garden City, Hertfordshire, UK.
authors: Naomi A
authors: NA
authors: Fineberg
authors: Michael P
authors: MP
authors: Hengartner
authors: Carmel
authors: C
authors: Bergbaum
authors: Tim
authors: T
authors: Gale
authors: Wulf
authors: W
authors: Rössler
authors: Jules
authors: J
authors: Angst
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology; D001714:Bipolar Disorder / Q000453:epidemiology; D016022:Case-Control Studies; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology; D013557:Switzerland / Q000453:epidemiology; D055815:Young Adult