• Compulsivity;
  • epidemiology;
  • obsessionality;
  • obsessive-compulsive disorder;
  • reward-model;
  • substance abuse;
  • substance dependence;
  • substance use disorder


Aim  Very little is known about the relationship between obsessive–compulsive disorder (OCD) and substance use disorder (SUD). The aim of this study is to compare the co-occurrence of OCD with SUD to the co-occurrence of SUD with other psychiatric disorders in a representative community sample.

Design  In order to examine the association of SUD and OCD, logistic regression analyses were used generating odds ratios and 95% confidence intervals for life-time prevalence and 12-month prevalence.

Setting and participants  Cross-sectional data were derived from the Netherlands Mental Health Survey and Incidence Study (NEMESIS), a large representative sample of the Dutch population (n = 7076).

Measurements  The Composite International Diagnostic Interview (CIDI) 1.1 was used to assess Diagnostic and Statistical Manual of Mental Disorders Axis I criteria for psychiatric disorders.

Findings  The life-time and 12-month odds of being diagnosed with SUD in subjects with OCD are significantly higher than the odds of SUD for people without a psychiatric disorder. In men, the co-occurrence of substance dependence and OCD is significantly higher than the co-occurrence of substance dependence and other psychiatric disorders, whereas in women this co-occurrence does not differ significantly.

Conclusions  The co-occurrence of substance dependence in obsessive–compulsive disorder is higher than the co-occurrence of substance dependence in other non-obsessive–compulsive disorder DSM disorders, especially in men.