Premium
Bipolar obsessive‐compulsive disorder and personality disorders
Author(s) -
Maina Giuseppe,
Albert Umberto,
Pessina Enrico,
Bogetto Filippo
Publication year - 2007
Publication title -
bipolar disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.285
H-Index - 129
eISSN - 1399-5618
pISSN - 1398-5647
DOI - 10.1111/j.1399-5618.2007.00508.x
Subject(s) - comorbidity , personality disorders , psychiatry , psychology , bipolar disorder , anxiety , mood disorders , clinical psychology , mood , personality , social psychology
Objectives: Relatively few systematic data exist on the clinical impact of bipolar comorbidity in obsessive‐compulsive disorder (OCD) and no studies have investigated the influence of such a comorbidity on the prevalence and pattern of Axis II comorbidity. The aim of the present study was to explore the comorbidity of personality disorders in a group of patients with OCD and comorbid bipolar disorder (BD). Methods: The sample consisted of 204 subjects with a principal diagnosis of OCD (DSM‐IV) and a Yale‐Brown Obsessive‐Compulsive Scale (Y‐BOCS) score ≥16 recruited from all patients consecutively referred to the Anxiety and Mood Disorders Unit, Department of Neuroscience, University of Turin over a period of 5 years (January 1998–December 2002). Diagnostic evaluation and Axis I comorbidities were collected by means of the Structured Clinical Interview for DSM‐IV Axis I Disorders (SCID‐I). Personality status was assessed by using the Structured Clinical Interview for DSM‐IV Axis II Disorders (SCID‐II). Socio‐demographic and clinical features (including Axis II comorbidities) were compared between OCD patients with and without a lifetime comorbidity of BD. Results: A total of 21 patients with OCD (10.3%) met DSM‐IV criteria for a lifetime BD diagnosis: 4 (2.0%) with BD type I and 17 (8.3%) with BD type II. Those without a BD diagnosis showed significantly higher rates of male gender, sexual and hoarding obsessions, repeating compulsions and lifetime comorbid substance use disorders, when compared with patients with BD/OCD. With regard to personality disorders, those with BD/OCD showed higher prevalence rates of Cluster A (42.9% versus 21.3%; p = 0.027) and Cluster B (57.1% versus 29.0%; p = 0.009) personality disorders. Narcissistic and antisocial personality disorders were more frequent in BD/OCD. Conclusions: Our results point towards clinically relevant effects of comorbid BD on the personality profiles of OCD patients, with higher rates of narcissistic and antisocial personality disorders in BD/OCD patients.