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Obsessive-compulsive disorder, major depressive disorder, and addiction: the vicious relationship

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Received: 15 September 2024
Published: 13 November 2024
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Obsessive-Compulsive Disorder (OCD) and Major Depressive Disorder (MDD) are prevalent psychiatric conditions, each affecting a substantial portion of the global population. When these conditions coexist with a Substance Use Disorder (SUD), the complexity of the clinical presentation is heightened. Herein, we describe two cases of individuals who have comorbid OCD and/or MDD and substance use disorder that highlight the importance of addressing the coexisting psychiatric illness when treating the SUD. These cases highlight the importance of tailored, multidisciplinary care, offering a potential therapeutic strategy based on medications for comprehensive recovery in individuals facing complex comorbid disorders. An integrated treatment approach, encompassing both psychiatric and substance treatment perspectives, is imperative.

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Kessler RC, Berglund P, Demler O, et al. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005;62:593–602. DOI: https://doi.org/10.1001/archpsyc.62.6.593

Leshner AI. Addiction is a brain disease, and it matters. Science 1997;278:45-7. DOI: https://doi.org/10.1126/science.278.5335.45

McLellan AT. Substance misuse and substance use disorders: Why do they matter in healthcare? Trans Am Clin Climatol Assoc 2017;128:112-30.

U.S. Department of Justice, National Drug Intelligence Center. National Drug Threat Assessment 2011. Published August 2011. Accessed 31 October 2023. Available from: https://www.justice.gov/archive/ndic/pubs44/44849/44849p.pdf

Mattson CL, Tanz LJ, Quinn K, et al. Trends and georgraphic patterns in drug and synthetic opioid overdose deaths – United States, 2013 – 2019. MMWR Morb Mortal Wkly Rep 2021;70:202-7. DOI: https://doi.org/10.15585/mmwr.mm7006a4

Ross S, Peselow E. Co-occurring psychotic and addictive disorders: Neurobiology and diagnosis. Clin Neuropharmacol 2012;35:235-43. DOI: https://doi.org/10.1097/WNF.0b013e318261e193

Veale D, Roberts A. Obsessive-compulsive disorder. BMJ 2014;348:g2183. DOI: https://doi.org/10.1136/bmj.g2183

American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Press, Washington, DC. 2013. DOI: https://doi.org/10.1176/appi.books.9780890425596

Conway KP, Compton W, Stinson FS, Grant BF. Lifetime comorbidity of DSM-IV mood and anxiety disorders and specific drug use disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry 2006;67:247-57. DOI: https://doi.org/10.4088/JCP.v67n0211

Virtanen S, Kuja-Halkola R, Sidorchuk A, et al. Association of obsessive-compulsive disorder and obsessive-compulsive symptoms with substance misuse in 2 longitudinal cohorts in Sweden. JAMA Netw Open 2022;5:e2214779. DOI: https://doi.org/10.1001/jamanetworkopen.2022.14779

Mancebo MC, Grant JE, Pinto A, Eisen JL, Rasmussen SA. Substance use disorders in an obsessive compulsive disorder clinical sample. J Anxiety Disord 2009;23:429-35. DOI: https://doi.org/10.1016/j.janxdis.2008.08.008

Quarantini LC, Torres AR, Sampaio AS, et al. Comorbid major depression in obsessive-compulsive disorder patients. Compr Psychiatry 2011;52:386-93. DOI: https://doi.org/10.1016/j.comppsych.2010.09.006

Hunt GE, Malhi GS, Lai HMX, Cleary M. Prevalence of comorbid substance use in major depressive disorder in community and clinical settings, 1990-2019: Systematic review and meta-analysis. J Affect Disord 2020;266:288-304. DOI: https://doi.org/10.1016/j.jad.2020.01.141

Brenner P, Brandt L, Li G, et al. Treatment-resistant depression as risk factor for substance use disorders-a nation-wide register-based cohort study. Addiction 2019;114:1274-82. DOI: https://doi.org/10.1111/add.14596

Badiani A, Belin D, Epstein D, et al. Opiate versus psychostimulant addiction: the differences do matter. Nat Rev Neurosci 2011;12:685-700. DOI: https://doi.org/10.1038/nrn3104

Grassi G. Addicted to compulsion: Assessing three core dimensions of addiction across obsessive-compulsive disorder and gambling disorder. CNS Spectrums. 2020. doi:10.1017/S1092852919000993 DOI: https://doi.org/10.1017/S1092852919000993

Kelly TM, Daley DC, Douaihy AB. Treatment of substance abusing patients with comorbid psychiatric disorders. Addict Behav 2012;37:11-24. DOI: https://doi.org/10.1016/j.addbeh.2011.09.010

Torrens M, Rossi PC, Martinez-Riera R, et al. Psychiatric co-morbidity and substance use disorders: treatment in parallel systems or in one integrated system? Subst Use Misuse 2012;47:1005-14. DOI: https://doi.org/10.3109/10826084.2012.663296

Kelly TM, Daley DC. Integrated treatment of substance use and psychiatric disorders. Soc Work Public Health 2013;28:388-406. DOI: https://doi.org/10.1080/19371918.2013.774673

Agabio R, Trogu E, Pani PP. Antidepressants for the treatment of people with co-occurring depression and alcohol dependence. Cochrane Database Syst Rev 2018;4:CD008581. DOI: https://doi.org/10.1002/14651858.CD008581.pub2

Hassan AN, Howe AS, Samokhvalov AV, et al. Management of mood and anxiety disorders in patients receiving opioid agonist therapy: Review and meta-analysis. Am J Addict 2017;26:551-63. DOI: https://doi.org/10.1111/ajad.12581

Xu J, Hao Q, Qian R, et al. Optimal dose of serotonin reuptake inhibitors for obsessive-compulsive disorder in adults: A systematic review and dose-response meta-analysis. Front Psychiatry 2021;12:717999. DOI: https://doi.org/10.3389/fpsyt.2021.717999

SAMHSA, Substance Abuse and Mental Health Services Administration. Obsessive-compulsive disorder and substance use disorders. Advisory 2016;15:1-9.

Torres AR, Ramos-Cerqueira AT, Ferrão YA, et al. Suicidality in obsessive-compulsive disorder: Prevalence and relation to symptom dimensions and comorbid conditions. J Clin Psychiatry 2011;72:17-26; Quiz 119-20. DOI: https://doi.org/10.4088/JCP.09m05651blu

Satel SL, McDougle CJ. Obsessions and compulsions associated with cocaine abuse. Am J Psychiatry 1991;148:947. DOI: https://doi.org/10.1176/ajp.148.7.947a

Koran LM, Aboujaoude E, Bullock KD, et al. Double-blind treatment with oral morphine in treatment-resistant obsessive-compulsive disorder. J Clin Psychiatry 2005;66:353-9. DOI: https://doi.org/10.4088/JCP.v66n0312

Sun J, Li Z, Buys N, Storch EA. Correlates of comorbid depression, anxiety and helplessness with obsessive-compulsive disorder in Chinese adolescents. J Affect Disord 2015;174:31-7. DOI: https://doi.org/10.1016/j.jad.2014.11.004

Tibi L, van Oppen P, van Balkom AJLM, et al. The long-term association of OCD and depression and its moderators: A four-year follow up study in a large clinical sample. Eur Psychiatry 2017;44:76-82. DOI: https://doi.org/10.1016/j.eurpsy.2017.03.009

Remijnse PL, van den Heuvel OA, Nielen MM, et al. Cognitive inflexibility in obsessive-compulsive disorder and major depression is associated with distinct neural correlates. PLoS One 2013;8:e59600. DOI: https://doi.org/10.1371/journal.pone.0059600

Rickelt J, Viechtbauer W, Lieverse R, et al. The relation between depressive and obsessive-compulsive symptoms in obsessive-compulsive disorder: Results from a large, naturalistic follow-up study. J Affect Disord 2016;203:241-7. DOI: https://doi.org/10.1016/j.jad.2016.06.009

Moritz S, Rufer M, Fricke S, et al. Quality of life in obsessive-compulsive disorder before and after treatment. Compr Psychiatry 2005;46:453-9. DOI: https://doi.org/10.1016/j.comppsych.2005.04.002

Dhillon S, Yang LP, Curran MP. Spotlight on bupropion in major depressive disorder. CNS Drugs 2008;22:613-7. DOI: https://doi.org/10.2165/00023210-200822070-00006

Vulink NCC, Denys D, Westenberg HGM. Bupropion for patients with obsessive-compulsive disorder: An open-label, fixed-dose study. J Clin Psychiatry 2005;66:228-30. DOI: https://doi.org/10.4088/JCP.v66n0211

Kellner M. Drug treatment of obsessive-compulsive disorder. Dialogues Clin Neurosci 2010;12:187-97. DOI: https://doi.org/10.31887/DCNS.2010.12.2/mkellner

Pittenger C, Bloch MH. Pharmacological treatment of obsessive-compulsive disorder. Psychiatr Clin North Am 2014;37:375-91. DOI: https://doi.org/10.1016/j.psc.2014.05.006

Bakhshaie J, Storch EA, Zvolensky MJ. Obsessive-compulsive symptoms and problematic alcohol use: The explanatory role of drinking motives. Addict Behav 2021;115:106734. DOI: https://doi.org/10.1016/j.addbeh.2020.106734

Öst LG, Enebrink P, Finnes A, et al. Cognitive behavior therapy for obsessive-compulsive disorder in routine clinical care: A systematic review and meta-analysis. Behav Res Ther 2022;159:104170. DOI: https://doi.org/10.1016/j.brat.2022.104170

How to Cite



1.
El-Mallakh RS, Shams J, Doroodgar M, Doroodgar M. Obsessive-compulsive disorder, major depressive disorder, and addiction: the vicious relationship. Eur J Transl Myol [Internet]. 2024 Nov. 13 [cited 2026 May 10];34(4). Available from: https://www.pagepressjournals.org/bam/article/view/13108