Citation

Amerio A. Indian J. Psychol. Med. 2019; 41(2): 133-137.

Affiliation

Mood Disorders Program, Tufts Medical Center, Boston, MA, USA.

Copyright

(Copyright © 2019, Indian Psychiatric Society, South Zone, Publisher Medknow Publications)

DOI

10.4103/IJPSYM.IJPSYM_367_18

PMID

30983660

PMCID

PMC6436414

Abstract

INTRODUCTION: The co-occurrence of bipolar disorder (BD) and obsessive-compulsive disorder (OCD) seemed to be a poor prognostic factor associated with greater disability, lower social and occupational functioning, poorer treatment response, and higher suicidal ideas and attempts compared to BD patients.

MATERIALS AND METHODS: A systematic review was conducted on the risk of suicide in BD-OCD patients compared to BD patients. Relevant papers published through August 2018 were identified searching the electronic databases MEDLINE, EMBASE, PsycINFO, and the Cochrane Library.

RESULTS: In all cases, diagnoses were according to the standard Diagnostic and Statistical Manual criteria and were established using validated assessment scales. More than 80% of the selected studies presented higher rates of history of suicide attempts and lifetime depressive episodes in BD-OCD patients compared to non-comorbid patients.

CONCLUSIONS: Osler's view that medicine should be a treatment of diseases, not of symptoms, is consistent with the approach of mood stabilization as the first objective in apparent BD-OCD patients, as opposed to immediate treatment with antidepressants. In line with that, especially in comorbid patients, lithium may be preferred because of its proven anti-suicidal effect.

Language: en

Keywords

Bipolar; comorbidity; obsessive-compulsive; suicide