Episodic obsessive-compulsive disorder and bipolar spectrum disorder: new evidence from a large Italian OCD sample

Abstract

Objectives

Obsessive-Compulsive Disorder (OCD) has been considered to be a chronic illness; however, some authors described a subtype of OCD characterised by symptom-free periods of time: Episodic-OCD (E-OCD). Only few studies focussed on this subtype of the disorder. The objectives of this research were to study the association between the episodic course of the disorder and lifetime psychiatric comorbidities and to investigate socio-demographic and other clinical features correlated to the episodic course.

Methods

The sample is composed of adult OCD patients. The course was defined episodic when at least one circumscribed symptom-free interval of at least 6 months was present. The sample was divided into two subgroups: Episodic-OCD and Chronic-OCD. Differences between groups were analysed with Student’s t-test, χ2 tests, Fisher test and multivariate logistic regression.

Results

Data regarding 585 individuals were collected. 14.2% (N = 83) of our sample had an episodic course. Bipolar I comorbid disorder, abrupt onset, lower severity of illness and lower rates of repeating compulsions were associated with the likelihood of having an E-OCD.

Conclusions

Our findings confirm that a significant proportion of OCD patients have an episodic course and that E-OCD could represent a specific endophenotype.

HIGHLIGHTS

• A significant proportion of OCD patients has an episodic course;

• Episodic OCD was related to comorbid Bipolar I Disorder;

• Episodic course was associated with an abrupt onset of OCD;

• Lower rates of repeating compulsions were associated with Episodic OCD.

Keywords:

• Obsessive-compulsive disorder
• episodic
• bipolar disorder
• course
• abrupt onset

Acknowledgements

The authors acknowledge the staff of our Department, which helped to collect all patients’ data.

Disclosure statement

Stefano Bramante is/has been a speaker and has received research grants from Angelini and Mylan. Giuseppe Maina is/has been a consultant and/or a speaker and/or has received research grants from Angelini, Boehringer Ingelheim, FB-Health, Janssen, Lundbeck, Otsuka, Mylan. Emina Mehanović, Roberta Borgogno, Luca Pellegrini and Sylvia Rigardetto have no competing interests to declare. Umberto Albert is/has been a consultant and/or a speaker and/or has received research grants from Angelini, Boehringer Ingelheim, FB-Health, Janssen, Lundbeck, Otsuka.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.