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22-12-2011 | Article

Substance dependence more common in OCD than other psychiatric disorders


Free abstract

MedWire News: Patients with obsessive-compulsive disorder (OCD) are more likely to have co-occurring substance dependence than those with other psychiatric disorders, an effect that is particularly notable in men, the results of a Dutch study indicate.

There are parallels between OCD and substance use disorder (SUD), such that OCD patients tend to obsess about something that they fear or perceive as unpleasant, while individuals with SUD obsess about something they experience as pleasant. In both disorders, there may be simultaneous ambivalence about these thoughts.

To examine the relative association between OCD and SUD, Damiaan Denys, from the University of Amsterdam, and colleagues studied data from the Netherlands Mental Health Survey and Incidence Study, focusing on a nationally representative sample of 7076 individuals interviewed in 1996. The World Health Organization Composite International Diagnostic Interview 1.1 was used to assess DSM Axis I criteria for all psychiatric disorders.

The lifetime and 12-month prevalence of SUD were lowest in individuals without a DSM disorder, higher in those with a DSM disorder other than OCD, and highest in those with OCD, the team reports in the journal Addiction. In all cases, the prevalence of SUD was higher in men than in women.

Logistic regression analysis revealed that individuals with OCD were significantly more likely than those without a DSM disorder to have a lifetime diagnosis of SUD, at odds ratios of 3.32 and 7.52 in men and women, respectively. The difference in the likelihood of SUD between those with OCD and those with a DSM disorder other than OCD did not reach significance. Similar results were seen for 12-month data.

The researchers also found that a lifetime diagnosis of substance dependence was significantly more common in OCD individuals than in those without a psychiatric disorder in both men and women. Furthermore, men with OCD were significantly more likely than those with a DSM disorder other than OCD to have a lifetime and 12-month diagnosis of substance dependence, at odds ratios of 3.06 and 2.25. The difference did not reach significance in women.

"These epidemiological data support the idea that substance use disorders especially SD, and OCD, may have a common biological vulnerability or a common neurobiological underpinning resulting in overlapping symptoms and a relatively high level of comorbidity," the team writes.

"This also means that patients with OCD (especially men) should always be screened for the presence of alcohol or drug dependence and treated for these disorders when indicated."

By Liam Davenport