Skip to main content
SpringerLink
Log in

The clinical impact of mood disorder comorbidity on obsessive–compulsive disorder

  • ORIGINAL PAPER
  • Published:
European Archives of Psychiatry and Clinical Neuroscience Aims and scope Submit manuscript

Abstract

The present study examines the effect of concomitant major depressive or bipolar disorder on clinical symptoms of patients with obsessive–compulsive disorder (OCD). Forty–nine patients classified as OCD without a mood disorder, 26 classified as OCD with bipolar disorder (OCD–BD) and 42 classified as OCD with major depressive disorder (OCD–MDD) according to DSM–IV diagnostic criteria were included in the study. The groups were compared with respect to demographic variables and scores obtained on various scales. The OCD–BD group had more symmetry/exactness obsessions and ordering/arranging compulsions, and a more episodic course of illness and had better insight compared to the other two groups. Levels of anxiety, depression, disability and obsessive–compulsive symptom severity were significantly higher in the OCDMDD group. The rate of social phobia was higher in OCD–BD patients, whereas the rates of generalized anxiety disorder and simple phobias were higher in OCDMDD group. These findings suggest that comorbidity of major depressive disorder may increase the severity of OCD symptoms. On the other hand, bipolar disorder comorbidity may constitute a subgroup which is characterized by a higher rate of episodic course and better insight.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Akiskal HS, Walker P, Puzantian VR, King D, Rosenthal TL, Dranon M (1983) Bipolar outcome in the course of depressive illness: Phenomenologic, familial, and pharmacologic predictors. J Affect Disord 5:115–112

    Article  PubMed  CAS  Google Scholar 

  2. Akiskal HS (2002) Classification, diagnosis and boundaries of bipolar disorders: A review. In:Maj M, Akiskal HS, Lopez–Ibor JJ, Sartorius N (eds) Bipolar disorder. John Wiley and Sons, West Sussex

  3. American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn (DSM–IV). American Psychiatric Press, Washington, DC

  4. Angst J, Dobler–Mikola A: The Zurich study, VI (1985) A continuum from depression to anxiety disorders? Eur Arch Psychiatry and Neurosci 235:179–186

    Article  CAS  Google Scholar 

  5. Angst J, Gamma A, Endrass J, Hantouche E, Goodwin R, Ajdacic V, Eich D, Rossler W (2005) Obsessive–compulsive syndromes and disorders: significance of comorbidity with bipolar and anxiety syndromes. Eur Arch Psychiatry Clin Neurosci 255:65–71

    Article  PubMed  Google Scholar 

  6. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571

    PubMed  CAS  Google Scholar 

  7. Bellodi L, Sciuto G, Diaferia G, Ronchi P, Smeraldi E (1992) Psychiatric disorders in the families of patients with obsessive–compulsive disorder. Psychiatry Res 42:111–120

    Article  PubMed  CAS  Google Scholar 

  8. Chen YW, Dilsaver SC (1995) Comorbidity for obsessive compulsive disorder in bipolar and unipolar disorders. Psychiatry Res 59:57–64

    Article  PubMed  CAS  Google Scholar 

  9. First MB, Spitzer RL, Gibbon M, Williams JBW (1997) Structured clinical interview for DSM–IV clinical version (SCID–I/CV). American Psychiatric Press, Washington DC

  10. Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischman RL, Hill CL, Heninger GR, Charney DS (1989) The Yale–Brown obsessive compulsive scale (Y–BOCS): Development, use and reliability. Arch Gen Psychiatry 46:1006–1011

    PubMed  CAS  Google Scholar 

  11. Goodman WK, Price LH, Rasmussen SA, Mazure C, Delgado P, Heninger GR, Charney DS (1989) The Yale–Brown obsessive compulsive scale (Y–BOCS): Validity. Arch Gen Psychiatry 46:1012–1016

    PubMed  CAS  Google Scholar 

  12. Hamilton M (1959) The assessment of anxiety states by rating. Br J Med Psychology 32:50–55

    CAS  Google Scholar 

  13. Hamilton M (1967) Development of a rating scale for primary depressive illness. Br J Soc Clin Psychology 6:278–296

    CAS  Google Scholar 

  14. Hecht H, Von Zerssen D, Krieg C, Possl J, Wittchen HU (1989) Anxiety and depression: Comorbidity, psychopathology and social functioning. Compr Psychiatry 30:420–433

    Article  PubMed  CAS  Google Scholar 

  15. Kolada JL, Bland RC, Newman SC (1994) Obsessive compulsive disorder. Acta Psychiatr Scand 376:24–35

    CAS  Google Scholar 

  16. Kruger S, Cooke RG, Hasey GM, Jorna T, Persad E (1995) Comorbidity of obsessive compulsive disorder in bipolar disorder. J Affect Disord 34:117–120

    Article  PubMed  CAS  Google Scholar 

  17. Lenane MC, Swedo SE, Leonard H, Pauls DL, Sceery W, Rapoport JL (1990) Psychiatric disorders in first degree relatives of children and adolescents with obsessive compulsive disorder. J Am Acad Child Adolesc Psychiatry 29:407–412

    PubMed  CAS  Google Scholar 

  18. Lensi P, Cassano GB, Correddu G, Ravagli S, Kunovac JL, Akiskal HS (1996) Obsessive–compulsive disorder: familial–developmental history, symptomatology, comorbidity and course with special reference to gender–related differences. Br J Psychiatry 169:101–107

    Article  PubMed  CAS  Google Scholar 

  19. Nestadt G, Samuels J, Riddle M, Bienvenu III OJ, Liang K–Y, LaBuda M, Walkup J, Grados M, Hoehn–Saric R (2000) A family study of obsessive–compulsive disorder. Arch Gen Psychiatry 57:358–363

    Article  PubMed  CAS  Google Scholar 

  20. Neziroglu F, McKay D, Yaryura–Tobias JA, Stevens KP, Todaro J (1999) The overvalued idea scale: Development, reliability and validity in obsessive–compulsive disorder. Behav Res Ther 37:881–902

    Article  PubMed  CAS  Google Scholar 

  21. Okasha A, Saad A, Khalil AH, el Dawla AS, Yehia N (1994) Phenomenology of obsessive compulsive disorder: A transcultural study. Compr Psychiatry 35:191–197

    Article  PubMed  CAS  Google Scholar 

  22. Pauls DL, Alsobrook II JP, Goodman W, Rasmussen S, Leckman JF (1995) A family study of obsessive–compulsive disorder. Am J Psychiatry 152:76–84

    PubMed  CAS  Google Scholar 

  23. Perugi G, Akiskal HS, Pfanner C, Presta S, Gemignani A, Milanfranchi A, Lensi P, Ravagli S, Cassano GB (1997) The clinical impact of bipolar and unipolar affective comorbidity on obsessive compulsive disorder. J Affect Disord 46:15–23

    Article  PubMed  CAS  Google Scholar 

  24. Perugi G, Akiskal HS, Gemignani A, Pfanner C, Presta S, Milanfranchi A, Lensi P, Ravagli S, Maremmani I, Cassano GB (1998) Episodic course in obsessive–compulsive disorder. Eur Arch Psychiatry Clin Neurosci 248:240–244

    Article  PubMed  CAS  Google Scholar 

  25. Rasmussen SA, Tsuang MT (1986) Clinical characteristics and family history in DSM–III obsessive–compulsive disorder. Am J Psychiatry 143:317–322

    PubMed  CAS  Google Scholar 

  26. Rasmussen SA, Eisen JL (1988) Clinical and epidemiologic findings of significance to neuropharmacologic trials in OCD. Psychopharmacol Bull 24:466–470

    PubMed  CAS  Google Scholar 

  27. Ravizza L, Maina G, Bogetto F (1997) Episodic and chronic obsessive– compulsive disorder. Depress Anxiety 6:154–158

    Article  PubMed  CAS  Google Scholar 

  28. Roy MA, Neale MC, Pedersen NL, Mathe AA, Kendler KS (1995) A twin study of generalized anxiety disorder and major depression. Psychol Med 25:1037–1049

    Article  PubMed  CAS  Google Scholar 

  29. Sheehan DV (1983) The Anxiety Disease. Scribner, New York

  30. Shwartz CM, Shen WW (1998) Is episodic obsessive compulsive disorder bipolar? A report of four cases. J Affect Disord 56:61–66

    Article  Google Scholar 

  31. Spielberger CD, Gorsuch RL, Lushene RE (1970) Manual for state–trait anxiety inventory. Consulting Psychologists Press, California

  32. Stavrakaki C, Vargo B (1986) The relationships of anxiety and depression: A review of literature. Br J Psychiatry 149:7–16

    Article  PubMed  CAS  Google Scholar 

  33. Strober M, Carlson G (1982) Bipolar illness in adolescents with major depression: Clinical, genetic, and psychopharmacologic predictors in a three–to four year prospective follow–up investigation. Arch Gen Psychiatry 39:549–555

    PubMed  CAS  Google Scholar 

  34. Tükel R, Polat A, Özdemir Ö, Aksüt D, Türksoy N (2002) Comorbid conditions in obsessive–compulsive disorder. Compr Psychiatry 43:204–209

    Article  PubMed  Google Scholar 

  35. Türksoy N, Tükel R, Özdemir Ö, Karalı A (2002) Comparison of clinical characteristics in good and poor insight obsessive–compulsive disorder. J Anxiety Disord 16:413–423

    Article  PubMed  Google Scholar 

  36. Wittchen HU, Essau L (1989) Natural course and spontaneous remissions of untreated anxiety disorders. In:Hand I, Wittchen HU (eds) Panic and phobias. Springer Verlag, Berlin

  37. Wittchen HU, Zhao S, Kessler RC, Eaton WW (1994) DSM–III–R generalized anxiety disorder in the National Comorbidity Survey. Arch Gen Psychiatry 51:355–364

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Istanbul University, Istanbul Faculty of Medicine, Department of Psychiatry, Capa Istanbul, Turkey

    R. Tükel M.D., H. Meteris M.D., A. Koyuncu M.D., A. Tecer M.D. &  O. Yazıcı M.D.

Authors
  1. R. Tükel M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. Meteris M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Koyuncu M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Tecer M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. O. Yazıcı M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to R. Tükel M.D..

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tükel, R., Meteris, H., Koyuncu, A. et al. The clinical impact of mood disorder comorbidity on obsessive–compulsive disorder. Eur Arch Psychiatry Clin Neurosci 256, 240–245 (2006). https://doi.org/10.1007/s00406-006-0632-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00406-006-0632-z

Key words

Search

Navigation