Cognitive Factors in Comorbidity of Bipolar Disorder During Remission and Obsessive Compulsive Disorder

Although recently number of studies about comorbidity of Bipolar Disorder (BPD) and Obsessive Compulsive Disorder (OCD) have increased, studies about OCD comorbidity in the remission period of the BPD diagnosed patients are limited. In this study, it is aimed to compare remitted BPD, Bipolar Disorder– Obsessive Compulsive Disorder comorbidity (BPD+OCD) and OCD patients in terms of cognitive processes. 34 patients diagnosed with BPD, 33 patients with BPD and OCD comorbidity, and 41 patients with OCD were included to this study. Young Mania Rating Scale (YMRS) and Hamilton Depression Rating Scale (HDRS) were used to evaluate whether the BPD patient were in remission or not. During the psychiatric interview with the patients, a form with questions regarding the sociodemographic information and clinical data was filled out. Yale Brown Obsessive Compulsive Rating Scale (YBOCS) was administered to the patients. The patients were asked to fill out the Metacognition Questionnaire (MCQ) and the Obsessive Beliefs Questionnaire (OBQ). There was no statistically significant difference between the patient groups in terms of sociodemographic data. There was no significant difference in YBOCS mean scores between the BPD+OCD and OCD groups but sexual obsessions were significantly higher in BPD+OCD group than OCD group (p<0.05). In Responsibility/Threat Estimation and Perfectionism/Certainty subscales of OBQ, the scores of the patients diagnosed with only OCD were statistically significantly higher than those of the patient groups diagnosed with BPD+OCD and BPD (p=0.001). Importance/Control of Thoughts subscale scores were significantly higher in both OCD and BPD+OCD patient groups compared to the BPD patient group (p=0.029). OCD and BPD+OCD groups scored significantly higher than BPD group in all MCQ subscales except Cognitive Confidence (p<0.05). When we look at the groups evaluated in our study; in terms of cognitive factors such as obsessive beliefs and metacognition, the OCD group consistently received higher scores than other groups. This is consistent with the emphasis on the cognitive aspect of OCD in the literature. Higher sexual obsessions existence in BPD+OCD group and higher Importance/Control of Thoughts subscale of OBQ scores in OCD and BPD-OCD groups supports the literature and the metacognitive theory of OCD.