Posted by madison88 on December 24, 2003, at 23:46:01
when i saw the title of this article i thought, wow, that is me. i was first treated for depression and OCD with Zoloft and then Paxil, but I got rather manic on those. my ocd is mostly obsessional and has become delusional at times when my mood is at either extreme. i am now on trileptal, welbutrin, and abilify and am ok i guess. anyway, i would love some feedback about the concept of cyclothymic OCD as a diagnostic entity. i am a psych student and this will probably become my thesis topic. so, anyone think this "fits" you?" should this be a diagnostic entity or should it just be left as comorbid cyclothymia/soft bipolar and OCD? here is the abstract and the article info:
Cyclothymic OCD: a distinct form?
Journal of Affective Disorders Vol 75, Issue 1, June 2003, pp1-10
Authors: Hantouche, Angst, Demonfaucon, Perugi, Lancrenon, AkiskalAbstract: Clinical research on the comorbidity of obsessive compulsive disorder (OCD) and other anxiety disorders has largely focused on depression. However in practice, resistant or severe OCD patients not infrequently suffer from a masked or hidden comorbid bipolar disorder. Method: The rate of bipolar comorbidity in OCD was systematically explored among 453 members of the French Association of patients suffering from OCD (AFTOC) as well as a psychiatric sample of OCD out-patients (n=175). As previous research by us has shown the epidemiologic and clinical sample to be similar, we combined them in the present analyses (n=628). To assess mood disorder comorbidity, we used structured self-rated questionnaires for major depression, hypomania and mania (DSM-IV criteria), self-rated Angst’s checklist of Hypomania and that for the Cyclothymic Temperament (French version developed by Akiskal and Hantouche). Results: According to DSM-IV definitions of hypomania/mania, 11% of the total combined sample was classified as bipolar (3% BP-I and 8% BP-II). When dimensionally rated, 30% obtained a cut-off score ≥10 on the Hypomania checklist and 50% were classified as cyclothymic. Comparative analyses were conducted between OCD with (n=302) versus without cyclothymia (n=272). In contrast to non-cyclothymics, the cyclothymic OCD patients were characterized by more severe OCD syndromes (higher frequencies of aggressive, impulsive, religious and sexual obsessions, compulsions of control, hoarding, repetition); more episodic course; greater rates of manic/hypomanic and major depressive episodes (with higher intensity and recurrence) associated with higher rates of suicide attempts and psychiatric admissions; and finally, a less favorable response to anti-OCD antidepressants and elevated rate of mood switching with aggressive behavior. Limitation: Hypomania and cyclothymia were not confirmed by diagnostic interview by a clinician. Conclusion: Our data extend previous research on “OCD-bipolar comorbidity” as a highly prevalent and largely under-recognized and untreated class of OCD patients. Furthermore, our data suggest that “cyclothymic OCD” could represent a distinct form of OCD. More attention should be paid to it in research and clinical practice.
poster:madison88
thread:293258
URL: http://www.dr-bob.org/babble/psycho/20031221/msgs/293258.html