Citation

Amerio A, Odone A, Liapis CC, Ghaemi SN. Acta Psychiatr. Scand. 2014; 129(5): 343-358.

Copyright

(Copyright © 2014, John Wiley and Sons)

DOI

10.1111/acps.12250

PMID

unavailable

Abstract

OBJECTIVE: At least 50% of bipolar disorder (BD) patients have an additional diagnosis, one of the most difficult to manage being obsessive-compulsive disorder (OCD). Defining the nosology of BD-OCD comorbidity has important clinical implications, given that treatments for OCD can worsen BD outcomes.

METHOD: A systematic review was conducted on: i) BD-OCD comorbidity lifetime prevalence and ii) on standard diagnostic validators: phenomenology, course of illness, heredity, biological markers, and treatment response. Relevant papers published through March 30th 2013 were identified searching the electronic databases MEDLINE, Embase, PsycINFO, and the Cochrane Library.

RESULTS: Sixty-four articles met inclusion criteria. Lifetime comorbidity prevalence was 11-21% in BD patients and 6-10% in OCD patients. Compared to non-comorbid subjects, BD-OCD has a more episodic course of OC symptoms (up to 75% vs. 3%), typically with worsening during depression (78%) and improvement during mania/hypomania (64%), as well as a higher total mean number of depressive episodes (8.9 ± 4.2 vs. 4.1 ± 2.7) and perhaps more antidepressant-induced mania/hypomania (39% vs. 9%).

CONCLUSION: In this first systematic review of BD-OCD comorbidity, it appears that OC symptoms are usually secondary to BD, rather than representing a separate disease. © 2014 John Wiley & Sons A/S.

Language: en

Keywords

Humans; human; systematic review; epidemiology; Behavioral Symptoms; Comorbidity; Prevalence; quality of life; bipolar disorder; Bipolar disorder; suicidal ideation; depression; prevalence; suicide attempt; Reproducibility of Results; diagnosis; Age of Onset; hospitalization; comorbidity; psychology; Obsessive-compulsive disorder; review; substance abuse; alcohol abuse; behavior; obsession; clinical feature; clomipramine; serotonin uptake inhibitor; priority journal; disease course; mental patient; family history; Bipolar Disorder; reproducibility; onset age; phenomenology; hypomania; atypical antipsychotic agent; diagnostic value; schizoaffective psychosis; compulsion; obsessive compulsive disorder; serotonin transporter; Obsessive-Compulsive Disorder; mood stabilizer; heredity; treatment response; validity; outcome assessment; Outcome Assessment (Health Care); disease management; Disease Management; Epidemiologic Studies; Yale Brown Obsessive Compulsive Scale; diagnostic test accuracy study