Skip to main content
Erschienen in: Social Psychiatry and Psychiatric Epidemiology 11/2006

01.11.2006 | ORIGINAL PAPER

Obsessive–compulsive disorder and personality disorder

Evidence from the British National Survey of Psychiatric Morbidity 2000

verfasst von: Albina R. Torres, MD, Paul Moran, MD, Paul Bebbington, PhD, Traolach Brugha, MD, Dinesh Bhugra, PhD, Jeremy W. Coid, MD, Michael Farrell, MD, Rachel Jenkins, MD, Glyn Lewis, PhD, Howard Meltzer, PhD, Martin Prince, MD

Erschienen in: Social Psychiatry and Psychiatric Epidemiology | Ausgabe 11/2006

Einloggen, um Zugang zu erhalten

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.
Literatur
1.
Zurück zum Zitat 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 80–89 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 80–89
2.
Zurück zum Zitat 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 98:128–134 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 98:128–134
3.
Zurück zum Zitat Mavissakalian M, Hamann MS, Jones B (1990) A comparison of DSM-III personality disorders in panic/agoraphobia and obsessive–compulsive disorder. Compr Psychiatry 31:238–244PubMedCrossRef Mavissakalian M, Hamann MS, Jones B (1990) A comparison of DSM-III personality disorders in panic/agoraphobia and obsessive–compulsive disorder. Compr Psychiatry 31:238–244PubMedCrossRef
4.
Zurück zum Zitat Baer L, Jenike MA (1992) Personality disorders in obsessive–compulsive disorder. Psych Clin N Am 15:803–812 Baer L, Jenike MA (1992) Personality disorders in obsessive–compulsive disorder. Psych Clin N Am 15:803–812
5.
Zurück zum Zitat Steketee G (1990) Personality traits and disorders in obsessive–compulsives. J Anx Dis 4:351–364CrossRef Steketee G (1990) Personality traits and disorders in obsessive–compulsives. J Anx Dis 4:351–364CrossRef
6.
Zurück zum Zitat Torres AR, Del Porto JA (1995) Comorbidity of Obsessive–compulsive disorder and personality disorders: a Brazilian controlled study. Psychopathology 28:322–329CrossRef Torres AR, Del Porto JA (1995) Comorbidity of Obsessive–compulsive disorder and personality disorders: a Brazilian controlled study. Psychopathology 28:322–329CrossRef
7.
Zurück zum Zitat Mataix-Cols D, Baer L, Rauch SL, Jenike MA (2000) Relation of factor-analysed symptom dimensions of obsessive–compulsive disorder to personality disorders. Acta Psych Scand 102:199–202CrossRef Mataix-Cols D, Baer L, Rauch SL, Jenike MA (2000) Relation of factor-analysed symptom dimensions of obsessive–compulsive disorder to personality disorders. Acta Psych Scand 102:199–202CrossRef
8.
Zurück zum Zitat Matsunaga H, Kiriike N, Matsui T, Miyata A, Iwasaki Y, Fujimoto K, Kasai S, Kojima M (2000) Gender differences in social and interpersonal features and personality disorders among Japanese patients with obsessive–compulsive disorder. Compr Psychiatry 41:266–272PubMedCrossRef Matsunaga H, Kiriike N, Matsui T, Miyata A, Iwasaki Y, Fujimoto K, Kasai S, Kojima M (2000) Gender differences in social and interpersonal features and personality disorders among Japanese patients with obsessive–compulsive disorder. Compr Psychiatry 41:266–272PubMedCrossRef
9.
Zurück zum Zitat Black DW, Noyes R (1997) Obsessive–compulsive disorder and axis II. Int Rev Psychiatry 9:111–118CrossRef Black DW, Noyes R (1997) Obsessive–compulsive disorder and axis II. Int Rev Psychiatry 9:111–118CrossRef
10.
Zurück zum Zitat Tyrer P, Simmonds S (2003) Treatment models for those with severe mental illness and comorbid personality disorder. Br J Psychiatry (Suppl 44):15–18 Tyrer P, Simmonds S (2003) Treatment models for those with severe mental illness and comorbid personality disorder. Br J Psychiatry (Suppl 44):15–18
11.
Zurück zum Zitat Moran P, Walsh E, Tyrer P, Burn T, Creed F, Fahy T (2003) Impact of comorbid personality disorder on violence in psychosis: report from the UK700 trial. Br J Psychiatry 182:129–134PubMedCrossRef Moran P, Walsh E, Tyrer P, Burn T, Creed F, Fahy T (2003) Impact of comorbid personality disorder on violence in psychosis: report from the UK700 trial. Br J Psychiatry 182:129–134PubMedCrossRef
12.
Zurück zum Zitat 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 34:1407–1418PubMedCrossRef 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 34:1407–1418PubMedCrossRef
13.
Zurück zum Zitat Goodwin RD, Brook JS, Cohen P (2005) Panic attacks and the risk of personality disorder. Psychol Med 35:227–235PubMedCrossRef Goodwin RD, Brook JS, Cohen P (2005) Panic attacks and the risk of personality disorder. Psychol Med 35:227–235PubMedCrossRef
14.
Zurück zum Zitat Zimmerman M (1994) Diagnosing personality disorders. A review of issues and research methods. Arch Gen Psychiatry 51:225–245PubMed Zimmerman M (1994) Diagnosing personality disorders. A review of issues and research methods. Arch Gen Psychiatry 51:225–245PubMed
15.
Zurück zum Zitat Diaferia G, Bianchi I, Bianchi ML, Cavedini P, Erzegovesi S, Bellodi L (1997) Relationship between obsessive–compulsive personality and obsessive–compulsive disorder. Compr Psychiatry 38:38–42PubMedCrossRef Diaferia G, Bianchi I, Bianchi ML, Cavedini P, Erzegovesi S, Bellodi L (1997) Relationship between obsessive–compulsive personality and obsessive–compulsive disorder. Compr Psychiatry 38:38–42PubMedCrossRef
16.
Zurück zum Zitat Ricciardi JN, Baer L, Jenike MA, Fischer SC, Sholtz D, Buttolph L (1992) Changes in DSM-III-R Axis II diagnoses following treatment of obsessive–compulsive disorder. Am J Psychiatry 149:829–831PubMed Ricciardi JN, Baer L, Jenike MA, Fischer SC, Sholtz D, Buttolph L (1992) Changes in DSM-III-R Axis II diagnoses following treatment of obsessive–compulsive disorder. Am J Psychiatry 149:829–831PubMed
17.
Zurück zum Zitat 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 7:53–59 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 7:53–59
18.
Zurück zum Zitat 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 87:456–462 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 87:456–462
19.
Zurück zum Zitat Karno M, Golding JM, Sorenson SB, Burnam A (1988) The epidemiology of obsessive–compulsive disorder in five US communities. Arch Gen Psychiatry 45:1094–1099PubMed Karno M, Golding JM, Sorenson SB, Burnam A (1988) The epidemiology of obsessive–compulsive disorder in five US communities. Arch Gen Psychiatry 45:1094–1099PubMed
20.
Zurück zum Zitat Kolada JL, Bland RC, Newman SC (1994) Epidemiology of psychiatric disorders in Edmonton. Obsessive–compulsive disorder. Acta Psych Scand Suppl 376:24–35 Kolada JL, Bland RC, Newman SC (1994) Epidemiology of psychiatric disorders in Edmonton. Obsessive–compulsive disorder. Acta Psych Scand Suppl 376:24–35
21.
Zurück zum Zitat Tyrer P, Mitchard S, Methuen C, Ranger M (2003) Treatment rejecting and treatment seeking personality disorders: type R and type S. J Pers Dis 17:263–268CrossRef Tyrer P, Mitchard S, Methuen C, Ranger M (2003) Treatment rejecting and treatment seeking personality disorders: type R and type S. J Pers Dis 17:263–268CrossRef
22.
Zurück zum Zitat 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, London 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, London
23.
Zurück zum Zitat Singleton N, Bumpstead R, O’Brien M, Meltzer H (2003) Psychiatric morbidity among adults living in private households, 2000. Int Rev Psychiatry 15:65–73PubMedCrossRef Singleton N, Bumpstead R, O’Brien M, Meltzer H (2003) Psychiatric morbidity among adults living in private households, 2000. Int Rev Psychiatry 15:65–73PubMedCrossRef
24.
Zurück zum Zitat Kish L (1965) Survey sampling. Willey, London Kish L (1965) Survey sampling. Willey, London
25.
Zurück zum Zitat First MB, Gibbon M, Spitzer RL (1997) Structured clinical interview for DSM-IV axis II personality disorders. American Psychiatric Press, Washington, DC First MB, Gibbon M, Spitzer RL (1997) Structured clinical interview for DSM-IV axis II personality disorders. American Psychiatric Press, Washington, DC
26.
Zurück zum Zitat Lewis G, Pelosi AJ (1990) Manual of the revised clinical interview schedule (CIS-R). Institute of Psychiatry, London Lewis G, Pelosi AJ (1990) Manual of the revised clinical interview schedule (CIS-R). Institute of Psychiatry, London
27.
Zurück zum Zitat Lewis G, Pelosi AJ, Araya R, et al. (1992) Measuring psychiatric disorder in the community: a standardized assessment for use by lay interviewers. Psychol Med 22:465–486PubMedCrossRef Lewis G, Pelosi AJ, Araya R, et al. (1992) Measuring psychiatric disorder in the community: a standardized assessment for use by lay interviewers. Psychol Med 22:465–486PubMedCrossRef
28.
Zurück zum Zitat Meltzer H, Gill B, Petticrew M, Hinds K (1995) The prevalence of psychiatric morbidity among adults living in private households. HMSO, London Meltzer H, Gill B, Petticrew M, Hinds K (1995) The prevalence of psychiatric morbidity among adults living in private households. HMSO, London
29.
Zurück zum Zitat Singleton N, Meltzer H, Gatward R (1998) Psychiatric morbidity among prisoners in England and Wales Stationary Office, London Singleton N, Meltzer H, Gatward R (1998) Psychiatric morbidity among prisoners in England and Wales Stationary Office, London
30.
Zurück zum Zitat Stata Corporation (2003) Stata statistical software: release 8.0. College Station, Stata Corporation, TX Stata Corporation (2003) Stata statistical software: release 8.0. College Station, Stata Corporation, TX
31.
Zurück zum Zitat Lewis G, Bebbington P, Brugha T, Farrell M, Gill B, Jenkins R, Meltzer H (2003) Socio-economic status, standard of living, and neurotic disorder. Int Rev Psychiatry 15:91–96PubMedCrossRef Lewis G, Bebbington P, Brugha T, Farrell M, Gill B, Jenkins R, Meltzer H (2003) Socio-economic status, standard of living, and neurotic disorder. Int Rev Psychiatry 15:91–96PubMedCrossRef
32.
Zurück zum Zitat 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 Psychiatry 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 Psychiatry
33.
Zurück zum Zitat 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 90:120–123 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 90:120–123
34.
Zurück zum Zitat Bejerot S, Ekselius L, von Knorring L (1998) Comorbidity between obsessive–compulsive disorder (OCD) and personality disorders. Acta Psych Scand 97:398–402 Bejerot S, Ekselius L, von Knorring L (1998) Comorbidity between obsessive–compulsive disorder (OCD) and personality disorders. Acta Psych Scand 97:398–402
35.
Zurück zum Zitat Nestadt G, Samuels JF, Romanoski AJ, Folstein MF, McHugh PR (1994) Obsessions and compulsions in the community. Acta Psych Scand 89:219–224 Nestadt G, Samuels JF, Romanoski AJ, Folstein MF, McHugh PR (1994) Obsessions and compulsions in the community. Acta Psych Scand 89:219–224
36.
Zurück zum Zitat Samuels J, Nestadt G, Bienvenu OJ, Costa PT, Riddle MA, Liang KIY, Hoehn-Saric R, Grados MA, Cullen BAM (2000) Personality disorders and normal personality dimensions in obsessive–compulsive disorder. Brit J Psychiatry 177:457–462CrossRef Samuels J, Nestadt G, Bienvenu OJ, Costa PT, Riddle MA, Liang KIY, Hoehn-Saric R, Grados MA, Cullen BAM (2000) Personality disorders and normal personality dimensions in obsessive–compulsive disorder. Brit J Psychiatry 177:457–462CrossRef
37.
Zurück zum Zitat Sobin C, Blundell ML, Weiller F, Gavigan C, Haiman C, Karayiorgou M (2000) Evidence of a schizotypy subtype in OCD. J Psych Res 34:15–24CrossRef Sobin C, Blundell ML, Weiller F, Gavigan C, Haiman C, Karayiorgou M (2000) Evidence of a schizotypy subtype in OCD. J Psych Res 34:15–24CrossRef
38.
Zurück zum Zitat Norman RMG, Davies F, Malla AK, Cortese L, Nocholson IA (1996) Relationship of obsessive–compulsive symptomatology to anxiety, depression and schizotypy in a clinical population. Br J Clin Psychol 35:553–566PubMed Norman RMG, Davies F, Malla AK, Cortese L, Nocholson IA (1996) Relationship of obsessive–compulsive symptomatology to anxiety, depression and schizotypy in a clinical population. Br J Clin Psychol 35:553–566PubMed
39.
Zurück zum Zitat Albert U, Maina G, Forner F, Bogetto F (2004) DSM-IV obsessive–compulsive personality disorder: prevalence in patients with anxiety disorders and in healthy comparison subjects. Compr Psychiatry 45:325–332PubMedCrossRef Albert U, Maina G, Forner F, Bogetto F (2004) DSM-IV obsessive–compulsive personality disorder: prevalence in patients with anxiety disorders and in healthy comparison subjects. Compr Psychiatry 45:325–332PubMedCrossRef
40.
Zurück zum Zitat Widiger TA (2000) Personality disorders in the 21st century. J Pers Dis 14:13–16 Widiger TA (2000) Personality disorders in the 21st century. J Pers Dis 14:13–16
Metadaten
Titel
Obsessive–compulsive disorder and personality disorder
Evidence from the British National Survey of Psychiatric Morbidity 2000
verfasst von
Albina R. Torres, MD
Paul Moran, MD
Paul Bebbington, PhD
Traolach Brugha, MD
Dinesh Bhugra, PhD
Jeremy W. Coid, MD
Michael Farrell, MD
Rachel Jenkins, MD
Glyn Lewis, PhD
Howard Meltzer, PhD
Martin Prince, MD
Publikationsdatum
01.11.2006
Erschienen in
Social Psychiatry and Psychiatric Epidemiology / Ausgabe 11/2006
Print ISSN: 0933-7954
Elektronische ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-006-0118-3

Weitere Artikel der Ausgabe 11/2006

Social Psychiatry and Psychiatric Epidemiology 11/2006 Zur Ausgabe

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.