EPISODIC COURSE IN OBSESSIVE-COMPULSIVE DISORDER

The course of obsessive-compulsive disorder (OCD) is variable, ranging from episodic to chronic. We hypothesised that the former course is m ore likely to be related to bipolar mood disorders. With the use of a specially constructed OCD questionnaire, we studied 135 patients fulfi lling DSM-III-R criteria for OCD with an illness duration of at least 10 years and divided by course: 27.4% were episodic and 72.6% chronic. We compared clinical and familial characteristics and comorbidity. Un ivariate analyses showed that episodic OCD had a significantly lower r ate of checking rituals and a significantly higher rate of a positive family history for mood disorder. Multivariate stepwise discriminant a nalysis revealed a positive and significant relationship between episo dic course, family history for mood disorders, lifetime comorbidity fo r panic and bipolar-II disorders, late age at onset and negative corre lation with generalized anxiety disorder. These data suggest that the episodic course of OCD has important clinical correlates which are rel ated to cyclic mood disorders. This correlation has implications for t reatment and research strategies on the aetiology within a subpopulati on of OCD.