The specific pattern of obsessive-compulsive symptoms in patients with bipolar disorder

BACKGROUND: Some preliminary findings have suggested that patients with bipolar disorder show a disparate pattern of obsessive-compulsive (OC) symptoms. This study aimed to reevaluate this subject on a different sample within a different cultural background. METHODS: The present cross-sectional study was carried out in a clinical non-experimental setting on 78 obsessivecompulsive disorder (OCD) patients; 39 with and 39 without bipolar disorder (BD). Subjects underwent a Structured Clinical Diagnostic Interview for DSM-IV (SCID-I) as well as the Yale-Brown Obsessive-Compulsive Rating Scale (YBOCS). RESULTS: The diagnoses in the non-bipolar group were mostly major depressive disorder (38%) and dysthymic disorder (38%). The mean age of the bipolar group was significantly lower than that of the non-bipolars (P(LESS THAN0.05). The mean score of the Y-BOCS was not significantly different between the two groups. The mean estimated number of obsessive themes - but not compulsive ones - in the bipolar group was significantly higher than that of the non-bipolars (P(LESS THANO.OOOl). The aggressive (P(LESS THANO.Ol), sexual (P(LESS THAN)O.OOOl) and religious (P(LESS THAN0.05) obsessions were significantly more prevalent, and the contamination obsession (P(LESS THAN0.05) was significantly less prevalent in the bipolar group. Also, in the bipolar group the miscellaneous compulsions (P(LESS THANO.O 1) were significantly more prevalent, and the washing compulsion (P(LESS THAN)O.OOl) was significantly less prevalent. CONCLUSIONS: The content of OC symptoms which is not traditionally considered a helpful factor for diagnosing a psychiatric disorder might be able to lead the clinician to the diagnosis of bipolarity in a depressed patient with OCD