Low comorbid obsessive-compulsive disorder in patients with major depressive disorder - Findings from a European multicenter study

Markus Dold; Lucie Bartova; Daniel Souery; Julien Mendlewicz; Stefano Porcelli; Alessandro Serretti; Joseph Zohar; Stuart Montgomery; Siegfried Kasper

doi:10.1016/j.jad.2017.10.033

Low comorbid obsessive-compulsive disorder in patients with major depressive disorder - Findings from a European multicenter study

J Affect Disord. 2018 Feb:227:254-259. doi: 10.1016/j.jad.2017.10.033. Epub 2017 Oct 28.

Authors

Markus Dold¹, Lucie Bartova¹, Daniel Souery², Julien Mendlewicz³, Stefano Porcelli⁴, Alessandro Serretti⁴, Joseph Zohar⁵, Stuart Montgomery⁶, Siegfried Kasper⁷

Affiliations

¹ Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
² Psy Pluriel, Centre Européen de Psychologie Médicale, Brussels, Belgium; Université Libre de Bruxelles, Brussels, Belgium.
³ Université Libre de Bruxelles, Brussels, Belgium.
⁴ Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy.
⁵ Psychiatric Division, Chaim Sheba Medical Center, Tel Hashomer, Israel.
⁶ Imperial College, University of London, London, United Kingdom.
⁷ Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria. Electronic address: gen-psychiatry@meduniwien.ac.at.

PMID: 29107818
DOI: 10.1016/j.jad.2017.10.033

Abstract

Background: This cross-sectional European multicenter study examined the association between major depressive disorder (MDD) and comorbid obsessive-compulsive disorder (OCD).

Methods: Socio-demographic, clinical, and treatment features of 1346 adult MDD patients were compared between MDD subjects with and without concurrent OCD using descriptive statistics, analyses of covariance (ANCOVA), and binary logistic regression analyses.

Results: We determined a point prevalence of comorbid OCD in MDD of 1.65%. In comparison to the MDD control group without concurrent OCD, a higher proportion of patients in the MDD + comorbid OCD group displayed concurrent panic disorder (31.81% vs 7.77%, p<.001), suicide risk (52.80% vs 44.81%, p=.04), polypsychopharmacy (95.45% vs 60.21%, p=.001), and augmentation treatment with antipsychotics (50.00% vs 25.46%, p=.01) and benzodiazepines (68.18% vs 33.31%, p=.001). Moreover, they were treated with higher mean doses of their antidepressant drugs (in fluoxetine equivalents: 48.99mg/day ± 18.81 vs 39.68mg/day ± 20.75, p=.04). In the logistic regression analyses, comorbid panic disorder (odds ratio (OR)=4.17, p=.01), suicide risk (OR=2.56, p=.04), simultaneous treatment with more psychiatric drugs (OR=1.51, p=<.05), polypsychopharmacy (OR=14.29, p=.01), higher antidepressant dosing (OR=1.01, p=<.05), and augmentation with antipsychotics (OR=2.94, p=.01) and benzodiazepines (OR=4.35, p=.002) were significantly associated with comorbid OCD.

Conclusion: In summary, our findings suggest that concurrent OCD in MDD (1) has a low prevalence rate compared to the reverse prevalence rates of comorbid MDD in OCD, (2) provokes higher suicide risk, and (3) is associated with a characteristic prescription pattern reflected by a high amount of polypsychopharmaceutical treatment strategies comprising particularly augmentation with antipsychotics and benzodiazepines.

Keywords: Antidepressants; Antipsychotics; Comorbidities; Major depressive disorder; Obsessive-compulsive disorder; Treatment response.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Comorbidity
Cross-Sectional Studies
Depressive Disorder, Major / epidemiology*
Europe / epidemiology
Female
Humans
Male
Middle Aged
Obsessive-Compulsive Disorder / epidemiology*
Prevalence
Risk Factors