Prevalence of Obsessive-Compulsive Disorder in Inpatient Substance Users and the Relative Comorbidities: A Study in Iranian Psychiatric Hospitals from 2019 to 2022.

OBJECTIVE: Obsessive-compulsive disorder (OCD) and substance use disorders (SUDs) are serious psychiatric conditions that frequently co-occur, complicating diagnosis and treatment. However, data on their comorbidity in Middle Eastern populations remains limited. This study investigated the prevalence of OCD and its psychiatric comorbidities among inpatient substance users in Iranian psychiatric hospitals.

METHODS: This cross-sectional study included 250 inpatients diagnosed with SUDs in Tehran between 2019 and 2022. Demographic, clinical, and psychiatric data were extracted from medical records. Logistic regression was used to examine associations between OCD and demographic/clinical variables.

RESULTS: The prevalence of OCD in the study population was 8.8%. The most commonly used substances were nicotine (91.6%), opioids (90%), and stimulants (79.2%). Comorbid psychiatric conditions were prevalent, with 32% diagnosed with Cluster B personality disorders, 14% with major depressive disorder (MDD), 10.8% with bipolar disorder, 9.6% with attention-deficit/hyperactivity disorder (ADHD), and 3.2% with post-traumatic stress disorder (PTSD). Among patients with OCD, MDD (22.7%), ADHD (13.6%), and PTSD (9.1%) were more common, although these differences were not statistically significant. Logistic regression analysis showed no significant associations between OCD and gender (OR = 1.44, 95% CI [0.57, 3.65], p = .447), age (OR = 0.97, 95% CI [0.92, 1.02], p = .221), or family history of psychiatric disorders (OR = 0.44, 95% CI [0.14, 1.33], p = .143).

CONCLUSION: OCD is relatively prevalent among individuals with SUDs and is frequently accompanied by other psychiatric disorders. Although no demographic predictors were statistically significant, these findings emphasize the need for routine OCD screening in addiction treatment settings to improve integrated care strategies.