Indian Journal of Psychiatry, 2002,44(4)377-379 OBSESSIVE COMPULSIVE DISORDER.CO-MORBIDITY IN MANIC PHASE OF BIPOLAR AFFECTIVE DISORDER HARISH KALRA, RAJUL TANDON.BHARAT SALUJA & INDRA MOHAN ABSTRACT Comorbidity is known to occur among various psychiatric disorders. About the third of the patients with Obsessive Compulsive Disorder have major depressive disorder and anxiety disorder but coexistence of Obsessive Compulsive Disorder with mania is rare to see. Here we report a case of Obsessive Compulsive Disorder where manic phase was accompanied by obsessions of contamination and pathological doubts along with cleaning rituals and spitting rituals. Keywords: Obsessive Compulsive Disorder, co-morbidity, bipolar affective disorder, mania The co-occurrence of bipolar affective manic phase which disappears in depressive disorder with other medical and psychiatric phase. We are reporting a case which highlights disorders has been little studied. Several this pattern of disorder. psychiatric disorder appear to occur with rates Mr. JPS is a 25 year old unmarried male. higher than expected including OCD (Obsessive He is farmer by occupation and a resident of Compulsive Disorder), bulimia nervosa, panic Barabanki (UP). disorder, impulse control disorder and substance abuse (Strakowski et al.,1994). A psychiatric CASE REPORT research study done at Material Sciences Institute, University of Texas, showed life time rates Mr. JPS was brought to the psychiatric of comorbidity of obsessive compulsive disorder hospital by his relatives after he was found to have to be 21% and 12.2% among bipolar and unipolar rigidity in all his four limbs, generalised fine patients respectively (Chen & Dilsaver, 1995). Also tremors, drooling of saliva and difficulty in described is social phobia followed by hypomania, speaking. Six months prior to admission he had as well as bipolar disorder manifesting as episodic begun to talk a lot, although not about anything OCD. In another work, studying the course of OCD in particular. The talktiveness was combind with co-occuring with bipolar disorder demonstrated an inappropriate behaviour, that was very interval course that frequently mirrored the course embarrassing to the rest of his family. He would of the bipolar disorder. Thus obsessive compulsive sing songs and dance and tell obscene jokes. syndrome may represent an alternative Not only was such behaviour completely out of expression of the bipolar disorder in same patients character for him, but he also did these things (Strakowski etal, 1998). with complete disregard to the circumstances He began walking excessively. He seemed unable to remain still for a second. His condition developed It is however unusual to see a case of bipolar affective disorder in which patient had OCD in 377