Bipolar obsessive-compulsive disorder and personality disorders.

Area of Science:

• Psychiatry
• Clinical Psychology
• Neuroscience

Background:

• Limited data exist on the clinical impact of bipolar disorder (BD) comorbidity in obsessive-compulsive disorder (OCD).
• No studies have investigated the influence of BD comorbidity on Axis II (personality disorder) comorbidity in OCD patients.
• Understanding these comorbidities is crucial for comprehensive patient assessment and treatment.

Purpose of the Study:

• To explore the comorbidity of personality disorders in patients with OCD and comorbid BD.
• To compare the prevalence and patterns of Axis II comorbidity between OCD patients with and without BD.

Main Methods:

• A cohort of 204 patients with a primary diagnosis of OCD (DSM-IV) and a Yale-Brown Obsessive-Compulsive Scale score >= 16 were assessed.
• Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and Axis II Disorders (SCID-II) were used for diagnostic evaluation.
• Socio-demographic and clinical features, including Axis II comorbidities, were compared between OCD patients with and without lifetime BD.

Main Results:

• 10.3% of OCD patients had a lifetime diagnosis of BD (4% BD type I, 8.3% BD type II).
• OCD patients without BD showed higher rates of male gender, sexual/hoarding obsessions, repeating compulsions, and substance use disorders.
• Patients with comorbid BD/OCD exhibited significantly higher rates of Cluster A (42.9% vs. 21.3%) and Cluster B (57.1% vs. 29.0%) personality disorders, including narcissistic and antisocial personality disorders.

Conclusions:

• Comorbid bipolar disorder significantly impacts the personality profiles of OCD patients.
• BD/OCD patients demonstrate elevated prevalence of Cluster A and B personality disorders.
• Narcissistic and antisocial personality disorders are more frequent in the combined BD/OCD population, suggesting distinct clinical implications.