HARISHKALRAefa/. insidiously. Along with these symptoms he started washing his hands excessively and would avoid walking behind the girls. He would say that he gets contaminated with dirt and pathogenes and required repeated washing. He would also admit that is wrong to do so but could not help it. Regarding avoiding walking behind the girls he would say that when he see them from behind, he would say that he had irresistible thought he would have anal sex with them and 3lso people would abuse him when he walks behind the girls. He would spit again and again to avoid such thoughts. With these complaints he was shown to a psychiatrist who prescribed him antipsychotics after which he developed parkinsonian features History: Mr.JPS had a normal birth and infancy. He had no problems in childhood and early adolescence and he did well at primary school and at middle school. He was a gentle and quite boy and was rather introverted. He liked to work in fields and to watch movies. He did not have a very active social life At the time of patient's referral, there was no history of neuropsychiatry illness in the family. Seven years previouosly JPS had has short lived episode of 3 weeks of elation, increased activity, talkativeness and decreased sleep. Then another similar episode with symptoms of successive and repetitive cleaning and washing in addition to manic features. The patient then switched into the episode of sadness, decreased talkativeness, lethargy and pessimistic talks. In this episode features of excessive and repetitive cleaning and washing were not present. Then there was similar episode of depression one year after this. Findings: Physical Examination: Fine tremors were present in fingers on extension, tongue tremors were also present. Cog wheel rigidity was present in all four limbs. Shoulder dropping was slow and glabeller tap reflex was present Speech was slurred. Mental State Examination Mr.JPS was of an average built, tidily and smartly dressed. He was talking incessantly in a slurred voice. There was pressure of speech and lost track of his thoughts several times by noises or minor details in surroundings. His mood fluctuated between irritability and elation. His thought content had grandiosity and obsession of contamination and pathological doubts. No perceptual abnormality was observed. He did not show any impairment in memory judgement was impaired. Investigations: All lab investigations were within normal limits. Course: The patient was treated with injection promethazine IV and trihexyphenydyl 2 mg TDS and lorazepam 2 mg TDS initially for one week. At the end of this period, his extrapyramidal symptoms disappeared. His grandiosity became more apparent and flow of speech increased. Then he was put on lithium 300mg TDS and dose of lorazepam was increased to 10mg, day. His psychomotor activity, grandiosity and pressure of speech decreased after 10 days. Simultaneously his behaviour therapy was started. The patient finally recovered completely after four weeks of treatment and was discharged from the hospital. DISCUSSION It is well known that obsessive compusive symptoms occur commonly during episodes of depression both unipolar as well as bipolar. Several studies (Krager et al.,1995,2000; Strakowsk et al.. 1998) have found variable rates of comorbidity between bipolar disorder and OCD from 8% to 35% . ECA study suggested 18 times higher risk for devolping OCD in bipolar euthymic patients in comparison to general population (Boyd et al., 1984). Appearance of obsessive compulsive disorder in manic phase in our patient is contrary to the findings of Gorden & Rasmussen(1986) & Keck et al.(1986) who have found inverse relation between mania and obsessive compulsive disorder. Recent study by Kruger et al.(2000) has found comorbid OCD to be more common in Bipolar II disorder in comparison to bipolar I however our case is a typical example of bipolar I disorder. This case report brings in light the possible hidden association between bipolar disorder and 378