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Background In the collaborative survey of AFTOC (French Association of patients suffering from OCD) in which 612 OCD patients were included, we observed a high rate of soft bipolar comorbidity in OCD: 30% with hypomanic episodes and 50% with cyclothymia, "Cyclothymic OCD" appeared as a distinct form with a different clinical picture, episodic course of illness; higher rate of recurrent depression; suicide attempts and psychiatric admissions; and less favorable response to anti-OCD drug therapy (Hantouche et al., 2003).

Resistant obsessive compulsive disorder (ROC): predictive factors and links with soft bipolarity