COMORBIDITY OF OBSESSIVE-COMPULSIVE DISORDER AND PERSONALITY-DISORDERS - A BRAZILIAN CONTROLLED-STUDY

The aim of this study was to evaluate the presence of personality diso rders (PDs) in 40 patients with obsessive-compulsive disorder (DSM-III -R criteria) from the Medical School of Botucatu (UNESP), Sao Paulo, B razil. It is a case-control study. Patients were 24 women and 16 men, 16-68 years old, referred to our outpatient psychiatric service for tr eatment. Controls were 40 nonpsychiatric outpatients matched to the ca ses by sex, age and marital status. The instrument used was the Portug uese version of the Structured Interview for DSM-III-R Personality Dis orders (SIDP-R). All interviews (n = 80) were made simultaneously by 2 raters, with independent scoring, so that the interrater reliability of the instrument could also be assessed (kappa statistics). The conse nsual axis II diagnoses in the OCD group were: avoidant (52.5%, kappa = 0.80), dependent (40%, kappa = 0.84), histrionic (20%, kappa = 0.83) , paranoid (20%, kappa = 0.74), obsessive-compulsive (17.5%, kappa = 0 .86), narcissistic (7.5%, kappa = 1.00), schizotypal(5%, kappa = 0.65) , passive-aggressive (5%, kappa = 0.79) and self-defeating (5%, kappa = 0.55). At least one PD diagnosis was made in 70% of the patients, wh ile only 6 controls had a PD diagnosis (p < 0.01). A great deal of dia gnostic overlap was found in the OCD group (57.5% had two or more PDs) , especially between avoidant and dependent PDs. The features of these two PDs may be secondary to the OCD. The study also suggests that the re is not a close relationship between OCD and obsessive-compulsive pe rsonality disorder (OCPD). Patients with OCPD or even 3 or 4 O-C trait s had significantly less insight into their obsessions and compulsions (p < 0.01).