Comorbid obsessive–compulsive disorder with bipolar disorder: A distinct form?

Abstract We examined whether the patients with Bipolar Disorder (BD) and Obsessive–Compulsive Disorder (OCD) comorbidity may represent a distinct form of BD. The subjects diagnosed with BD ( n =48), OCD ( n =61), and BD with OCD ( n =32) were compared in terms of several socio-demographic and clinical characteristics. Previous history of suicidal attempts was more likely to be higher in BD–OCD group compared to the other two groups. A more episodic course of OCD, higher rates of rapid cycling, and the seasonality were found in BD–OCD patients. The frequency of bipolar II and NOS subtypes was more prevalent in patients with BD–OCD than in OCD patients. The first diagnosed illness was BD in the majority of BD–OCD cases. It was found that first affective episode was major depression in half of BD–OCD patients. Age at onset of BD was found to be earlier in BD–OCD group compared to pure BD patients. Bipolarity may not have a specific effect on the phenomenology of OC symptoms. The episodic course of OCD, seasonality, rapid cycling, earlier onset of BD, and impulsivity in BD–OCD patients may be indicative for a distinct form of BD.