Obsessive–compulsive disorder and personality disorder
- 423 Downloads
Previous studies indicate that most individuals with obsessive–compulsive disorder (OCD) have comorbid personality disorders (PDs), particularly from the anxious cluster. However, the nature and strength of this association remains unclear, as the majority of previous studies have relied heavily on clinical populations. We analysed the prevalence of screen positive personality disorder in a representative sample of adults with OCD living in private households in the UK.
A secondary analysis of data from the 2000 British National Survey of Psychiatric Morbidity. The prevalence of PD, as determined by the SCID-II questionnaire, was compared in participants with OCD, with other neuroses and non-neurotic controls. Within the OCD group we also analysed possible differences relating to sex and subtypes of the disorder.
The prevalence of any screen positive PD in the OCD group (N = 108) was 74%, significantly greater than in both control groups. The most common screen positive categories were paranoid, obsessive–compulsive, avoidant, schizoid and schizotypal. Compared to participants with other neuroses, OCD cases were more likely to screen positively for paranoid, avoidant, schizotypal, dependent and narcissistic PDs. Men with OCD were more likely to screen positively for PDs in general, cluster A PDs, antisocial, obsessive–compulsive and narcissistic categories. The presence of comorbid neuroses in people with OCD had no significant effect on the prevalence of PD.
Personality pathology is highly prevalent among people with OCD who are living in the community and should be routinely assessed, as it may affect help-seeking behaviour and response to treatment.
Key wordsobsessive–compulsive disorder personality pathology personality disorders screening comorbidity epidemiological survey
The survey was carried out by Social Survey Division of the Office for National Statistics on behalf of the Department of Health, the Scottish Executive and the National Assembly for Wales.
Dr. A.R. Torres received a postdoctoral scholarship from CAPES, a Foundation subordinated to the Ministry of Education of Brazil, to develop this study at the Institute of Psychiatry, King’s College, London, UK.
- 1.Tyrer P (2000) Comorbidity of personality and mental state disorders. In: Tyrer P (ed) Personality disorders: diagnosis, management and course, 2nd edn. Butterworth-Heinemann, Oxford, pp 80–89Google Scholar
- 2.Matsunaga H, Kiriike N, Miyata A, Iwasaki Y, Matsui T, Nagata MT, Takei Y, Yamagami S (1998) Personality disorders in patients with obsessive–compulsive disorder in Japan. Acta Psych Scand 98:128–134Google Scholar
- 4.Baer L, Jenike MA (1992) Personality disorders in obsessive–compulsive disorder. Psych Clin N Am 15:803–812Google Scholar
- 10.Tyrer P, Simmonds S (2003) Treatment models for those with severe mental illness and comorbid personality disorder. Br J Psychiatry (Suppl 44):15–18Google Scholar
- 12.Klump KL, Strober M. Bulik CM, Thornton L, Johnson C, Devlin B, Fichter M, Halmi KA, Kaplan AS, Woodside DB, Crow S, Mitchell J, Rotondo A, Kell PK, Berrettini WH, Plotnicov K, Pollice C, Lilenfeld LR, Kaye WH (2004) Personality characteristics of women before and after recovery from an eating disorder. Psychol Med 34:1407–1418PubMedCrossRefGoogle Scholar
- 17.Ronchi P, Abbruzzese M, Erzegovesi S, Diaferia G, Sciuto G, Bellodi L (1992) The epidemiology of obsessive–compulsive disorder in a Italian population. Eur Psychiatry 7:53–59Google Scholar
- 18.Thompsen PH, Mikkelssen HU (1993) Development of personality disorders in children and adolescents with obsessive–compulsive disorder: a 6–22 year follow-up study. Acta Psych Scand 87:456–462Google Scholar
- 20.Kolada JL, Bland RC, Newman SC (1994) Epidemiology of psychiatric disorders in Edmonton. Obsessive–compulsive disorder. Acta Psych Scand Suppl 376:24–35Google Scholar
- 22.Singleton N, Bumpstead R, O’Brien M, Lee A, Meltzer H (2001) Psychiatric morbidity among adults living in private households, 2000: summary report: the report of a survey carried out by Social Survey Division of the Department of Health, the Scottish Executive and the National Assembly for Wales, LondonGoogle Scholar
- 24.Kish L (1965) Survey sampling. Willey, LondonGoogle Scholar
- 25.First MB, Gibbon M, Spitzer RL (1997) Structured clinical interview for DSM-IV axis II personality disorders. American Psychiatric Press, Washington, DCGoogle Scholar
- 26.Lewis G, Pelosi AJ (1990) Manual of the revised clinical interview schedule (CIS-R). Institute of Psychiatry, LondonGoogle Scholar
- 28.Meltzer H, Gill B, Petticrew M, Hinds K (1995) The prevalence of psychiatric morbidity among adults living in private households. HMSO, LondonGoogle Scholar
- 29.Singleton N, Meltzer H, Gatward R (1998) Psychiatric morbidity among prisoners in England and Wales Stationary Office, LondonGoogle Scholar
- 30.Stata Corporation (2003) Stata statistical software: release 8.0. College Station, Stata Corporation, TXGoogle Scholar
- 32.Torres AR, Prince MJ, Bebbington PE, Bhugra D, Brugha TS, Farrell M, Jenkins R, Lewis G, Meltzer H, Singleton N (in press) Obsessive–compulsive disorder: prevalence, comorbidity, impact and help-seeking in the UK National Psychiatric Morbidity Survey of 2000. Am J PsychiatryGoogle Scholar
- 33.Ekselius L, Lindstrom E, Von Knorring L, Bodlund O, Kullgren G (1994) SCID II interviews and the SCID screen questionnaire as diagnostic tools for personality disorders in DSM-III-R. Acta Psych Scand 90:120–123Google Scholar
- 34.Bejerot S, Ekselius L, von Knorring L (1998) Comorbidity between obsessive–compulsive disorder (OCD) and personality disorders. Acta Psych Scand 97:398–402Google Scholar
- 35.Nestadt G, Samuels JF, Romanoski AJ, Folstein MF, McHugh PR (1994) Obsessions and compulsions in the community. Acta Psych Scand 89:219–224Google Scholar
- 40.Widiger TA (2000) Personality disorders in the 21st century. J Pers Dis 14:13–16Google Scholar