Comorbidity

Comorbid psychopathology is common among patients with OCD. In a recently published study of a large health maintenance organization (HMO) population in northern California, 75 percent of adults with OCD were found to have at least one comorbid psychiatric diagnosis. Major depression affected 56 percent, other anxiety disorders affected 26 percent, including panic disorder and generalized anxiety disorder, and adjustment disorder affected 12 percent of the adult patients sampled (Fireman et al., 2001). The cross-national epidemiological study done by Weissman and colleagues also found that adults with OCD were at a substantially higher risk for having comorbid major depression or another anxiety disorder than persons without OCD at all seven sites in the study. Unlike the California HMO study, the risk of a comorbid anxiety disorder was found to be greater than the risk for a major depression. The overall proportion of persons with OCD who had a comorbid anxiety disorder (range 24.5 to 69.6 percent) was greater than those who had a comorbid major depression (range 12.4 to 60.3 percent). In the sample taken from the United States within this study, major depression affected 27 percent and another anxiety disorder affected 49 percent of adults with OCD (Weissman et al., 1994).

The patterns of comorbidity among childhood-onset cases are generally comparable to those for adult samples, with tic disorders and specific developmental disorders appearing more frequently in the pediatric populations. The California HMO study found that attention deficit hyperactivity disorder (ADHD) occurred most commonly

(34 percent), closely followed by major depression (33 percent), Tourette disorder (18 percent), oppositional defiant disorder (17 percent), and overanxious disorder (16 percent) (Fireman et al., 2001). The pattern of comorbidity found in this study was similar to that previously observed in the National Institute of Mental Health (NIMH) pediatric OCD cohort, where only 26 percent of the pediatric subjects had OCD as a single diagnosis. Tic disorders (30 percent), major depression (26 percent), and specific developmental disabilities (24 percent) were the most common comorbidities found. Rates were also increased for simple phobias (17 percent), overanxious disorder (16 percent), adjustment disorder with depressed mood (13 percent), oppositional disorder (11 percent), attention deficit disorder (10 percent), conduct disorder (7 percent), separation anxiety disorder (7 percent), and enuresis/encopresis (4 percent) (Swedo et al., 1989).

How To Win Your War Against Anxiety Disorders

How To Win Your War Against Anxiety Disorders

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