Serum Lipids among Drug Naïve or Drug-Free Patients with Obsessive Compulsive Disorder and their Association with Impulsivity: A Comparative Study

BACKGROUND

The derangement of serum lipids is well documented in psychiatric disorders like schizophrenia, mania, and depression but not in obsessive compulsive disorder (OCD), where it has been inadequately examined. Also, serum lipid abnormalities are increasingly found in "impulsivity," an important sub-construct of OCD. Our study aimed to examine serum lipid profile among patients with OCD and its association with clinical profile and impulsivity among them.

METHODS

Forty drug naïve or drug-free (four weeks for oral and eight weeks for any depot psychotropics) patients with OCD according to International Classification of Disease -10th version (ICD-10): Diagnostic Criteria for Research (DCR) by the World Health Organization (WHO), from outpatient and inpatient departments of a tertiary care psychiatric hospital were recruited. Measures like Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Hamliton Rating Scale for Depression (HAM-D), Barratt's Impulsivity Scale (BIS-11), and Hamilton Rating Scale for Anxiety (HAM-A) were administered. Forty age and sex-matched healthy controls (HC) were recruited after screening with General Health Questionnaire 12 (GHQ-12). Serum lipids were assessed in both the groups.

RESULTS

Serum high density lipoproteins (HDL) (P < 0.001; partial η2 = 0.176) and apolipoprotein B (P < 0.001; partial η2 = 0.531) were significantly higher in OCD group than age- and sex-matched HC. A trend toward lower serum HDL (P = 0.06; partial η2 = 0.060) was observed among patients of OCD with high impulsivity. Serum HDL was negatively correlated with BIS attention (rs =-0.32; p = 0.03), BIS motor (rs = 0.40; P = 0.01), BIS non-planning (rs = - 0.36; P = 0.02), and BIS total (rs = - 0.36; P = 0.01) scores. Serum triglycerides (TG) (rs = 0.34; P = 0.03) and apolipoprotein B (rs = -0.32; P = 0.04) were negatively correlated with Y-BOCS compulsion score. Serum TG (rs = -0.45, P < 0.01) and serum very low density lipoprotein (VLDL) was negatively (rs = -0.39; P = 0.01) correlated with Y-BOCS total scores. Serum VLDL was positively (rs = 0.34; P = 0.03) correlated with BIS motor scores.

CONCLUSIONS

Serum lipid fractions are deranged among patients with OCD. Different lipid fractions have different associations with clinical profiles of OCD. Impulsivity among patients with OCD may have a specific association with serum lipids. A small sample size, use of self-report measure without adaptation for impulsivity, a lack of metabolic profile assessment among participants, and a lack of assessment of impulsivity among HC were the limitations of our tudy.