Comorbid obsessive-compulsive disorder and bipolar disorder in a highly endogamous population: which came first?

ABSTRACT

Co-occurrence of bipolar disorder (BD) and obsessive compulsive disorder (OCD) is a common and difficult comorbid condition to manage. The aim of this study was to determine the prevalence of comorbidity with OCD among BD patients in a highly endogamous population. A cohort study was carried out on 396 patients enrolled between November 2011 and October 2013. Patients were grouped in BD patients with OCD (BD-OCD) and BD patients without OCD, rated for mania and depression and scored for OCD morbidity. We found significant differences in level of education (p = 0.022), occupation status (p = 0.025), household income, (p = 0.049), cigarette smoking (p = 0.038), sheesha smoking (narghile, water pipe, hookah or hubble bubble smoking) (p = 0.007) and prevalence of consanguinity (p = 0.036) among these groups. Number of hospitalizations and Young Mania Rating Scale score were not different among BD patients with or without OCD, whereas there were significant differences in Ham-D score, Clinical Global Impression for bipolar disorder Score, duration of illnesses and Global Assessment of Functioning. Also, specific phobia, somatization, depression, mania, any mood disorder, oppositional defiant disorder, Attention Deficit Hyperactivity Disorder and personality disorder were more common in BD than OCD–BD group. This study confirms that BD-OCD is a common comorbidity, largely under-recognized in clinical practice, which may significantly change BD presentation and outcome.

KEYWORDS:

• Prevalence
• consanguinity
• bipolar disorder
• obsessive-compulsive
• comorbidity

Acknolwledgements

The authors would like to thank the Hamad Medical Corporation for their support and ethical approval.

Notes on contributors

Abdulbari Bener is Professor of Public Health at the Cerrahpaşa Faculty of Medicine, Istanbul University. He was Professor of Public Health in the Department of Public Health at the Weill Cornell Medical College, and Asst. Medical Director and Head of the Medical Statistics & Epidemiology Department at Hamad Medical Corporation, Qatar, during August 2002–July 2014. In addition, he is also advisor to World Health Organization and Adjunct Professor & Coordinator for the postgraduate and master public health programs (MPH) of the School of Epidemiology and Health Sciences, University of Manchester.

Dr Elnour E. Dafeeah is Sr. Clinical Psychologist & psychotherapist consultant at Hamad Medical Corporation – Hamad Medical Corporation, Department of Psychiatry, Rumeilah Hospital, Hamad Medical Corporation, Qatar.

Dr Majid Al Abdulla currently is holding a position as consultant and acting Chairman, at the Department of Psychiatry, Rumeilah Hospital, Hamad Medical Corporation, Qatar.

Mohammed T. Abou-Saleh is Professor of Psychiatry, St George’s, University of London; Director of Research and Development and Clinical Director of Addiction Services for South West London and St George’s Mental Health Trust; Chairman of the World Psychiatric Association Section on Biological Psychiatry Consultant for the World Health Organization; and Vice-President for the Constituency Development of the World Federation for Mental Health.

Dr Antonio Ventriglio’s research areas are Schizophrenia and Bipolar Disorder Clinic, and he served at the Mc Lean Hospital Harvard University, Belmont, MA, USA. His current areas of interest are Social Psychiatry, Psychopharmacology, Medicine and Psychiatry. He holds position at the Department of Mental Health and the Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.

Additional information

Funding

This study was generously supported and funded by the Qatar Diabetes Association, Qatar Foundation. The authors would like to thank the Hamad Medical Corporation for their support and ethical approval (HMC RP # 11187/11 and HMC RP # 12061/12).