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Bipolar disorder and comorbid obsessive-compulsive disorder is associated with higher rates of anxiety and impulse control disorders

Published online by Cambridge University Press:  24 June 2014

Cilly Klüger Issler ,
Emel Serap Monkul ,
José Antonio de Mello Siqueira Amaral ,
Renata Sayuri Tamada ,
Roseli Gedanke Shavitt ,
Eurípedes C. Miguel  and
Beny Lafer
Cilly Klüger Issler
Affiliation:
Bipolar Disorder Research Program, Department of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
Emel Serap Monkul
Affiliation:
Bipolar Disorder Research Program, Department of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
José Antonio de Mello Siqueira Amaral
Affiliation:
Bipolar Disorder Research Program, Department of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
Renata Sayuri Tamada
Affiliation:
Bipolar Disorder Research Program, Department of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
Roseli Gedanke Shavitt
Affiliation:
Obsessive-Compulsive Disorder Research Program, Department of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
Eurípedes C. Miguel
Affiliation:
Obsessive-Compulsive Disorder Research Program, Department of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
Beny Lafer*
Affiliation:
Bipolar Disorder Research Program, Department of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
*
Dr Beny Lafer, PROMAN – Programa de Transtorno Bipolar, R. Dr. Ovídio Pires de Campos, 785 – 3° andar – Ala Sul Sala 04, Cerqueira Cesar – CEP 05403-010, São Paulo / SP / Brasil. Tel/Fax: +55 (11) 30697928; E-mail: blafer@usp.br
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Abstract

Issler CK, Monkul ES, Amaral JAMS, Tamada RS, Shavitt RG, Miguel EC, Lafer B. Bipolar disorder and comorbid obsessive-compulsive disorder is associated with higher rates of anxiety and impulse control disorders.

Objective:

Although bipolar disorder (BD) with comorbid obsessive-compulsive disorder (OCD) is highly prevalent, few controlled studies have assessed this comorbidity. The objective of this study was to investigate the clinical characteristics and expression of comorbid disorders in female BD patients with OCD.

Method:

We assessed clinically stable female outpatients with BD: 15 with comorbid OCD (BD+OCD group) and 15 without (BD/no-OCD group). All were submitted to the Structured Clinical Interview for DSM-IV, with additional modules for the diagnosis of kleptomania, trichotillomania, pathological gambling, onychophagia and skin picking.

Results:

The BD+OCD patients presented more chronic episodes, residual symptoms and previous depressive episodes than the BD/no-OCD patients. Of the BD+OCD patients, 86% had a history of treatment-emergent mania, compared with only 40% of the BD/no-OCD patients. The following were more prevalent in the BD+OCD patients than the BD/no-OCD patients: any anxiety disorder other than OCD; impulse control disorders; eating disorders; and tic disorders.

Conclusion:

Female BD patients with OCD may represent a more severe form of disorder than those without OCD, having more depressive episodes and residual symptoms, and being at a higher risk for treatment-emergent mania, as well as presenting a greater anxiety and impulse control disorder burden.

Keywords

obsessive-compulsive disorderbipolar disordercomorbidityimpulse control disorders
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 22 , Issue 2 , April 2010 , pp. 81 - 86
Copyright
Copyright © 2010 John Wiley & Sons A/S

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References

Chen, YW, Dilsaver, SC.Comorbidity for obsessive-compulsive disorder in bipolar and unipolar disorders. Psychiatry Res 1995;59:57–64. CrossRefGoogle ScholarPubMed
Angst, J, Gamma, A, Endrass, Jet al. Obsessive compulsive syndromes and disorders: significance of comorbidity with bipolar disorder and anxiety syndromes. Eur Arch Psychiatry Clin Neurosci 2005;255:65–71. CrossRefGoogle ScholarPubMed
Dilsaver, SC, Akiskal, HS, Akiskal, KK, Benazzi, F.Dose-response relationship between number of comorbid anxiety disorders in adolescent bipolar/unipolar disorders, and psychosis, suicidality, substance abuse and familiality. J Affect Disord 2006;96:249–258. CrossRefGoogle ScholarPubMed
Grabe, HJ, Meyer, C, Hapke, Uet al. Lifetime-comorbidity of obsessive-compulsive disorder and subclinical obsessive-compulsive disorder in Northern Germany. Eur Arch Psychiatry Clin Neurosci 2001;251:130–135. CrossRefGoogle ScholarPubMed
Krüger, S, Braunig, P, Cooke, RG.Comorbidity of obsessive-compulsive disorder in recovered inpatients with bipolar disorder. Bipolar Disord 2000;2:71–74. CrossRefGoogle ScholarPubMed
Centorrino, F, Hennen, J, Mallya, G, Egli, S, Clark, T, Baldessarini, RJ.Clinical outcome in patients with bipolar I disorder, obsessive compulsive disorder or both. Hum Psychopharmacol Clin Exp 2006;21:189–193. CrossRefGoogle ScholarPubMed
Issler, CK, Amaral, JAMS, Tamada, RSet al. Clinical expression of obsessive-compulsive disorder in women with bipolar disorder. Rev Bras Psiquiatr 2005;27:139–142. CrossRefGoogle ScholarPubMed
First, MB, Spitzer, RL, Gibson, Met al. Structured clinical interview for DSM-IV Axis I disorders – patient edition (version 2.0, 8/98 revision). New York, Biometrics Research Department; 1997. Google Scholar
Goodman, WK, Price, LH, Rasmussen, SAet al. The Yale-Brown Obsessive Compulsive Scale: development, use and reliability. Arch Gen Psychiatry 1989;46:1006–1011. CrossRefGoogle ScholarPubMed
First, MB.Structured clinical interview for DSM-IV-TR Impulse Control Disorders Not Elsewhere Classified (SCID-TCIm). Biometrics Research Department; New York State Psychiatric Institute; September 2004. Google Scholar
Leckman, JF, Riddle, MA, Hardin, MTet al. The Yale Global Tic Severity Scale: initial testing of a clinician-rated scale of tic severity. J Am Acad Child Adolesc Psychiatry 1989;28:566–573. CrossRefGoogle ScholarPubMed
Orvaschel, H, Pui̇g-Anti̇ch, J.Kiddie-SADS-E: Schedule for affective disorder and Schizophrenia for school-age children – epidemiologic version (4th version). Ft. Lauderdale, Fl. Nova University, Center for Psychological Study; 1987. Google Scholar
Sachs, GS.Bipolar mood disorder: practical strategies for acute and maintenance phase treatment. J Clin Psychopharmacol 1996;(2 Suppl. 1):32S–47S. CrossRefGoogle ScholarPubMed
Stoll, AL, Mayer, PV, Kolbrener, Met al. Antidepressant-associated mania: a controlled comparison with spontaneous mania. Am J Psychiatry 1994;151: 1642–1645. Google Scholar
Rosari̇o-Campos, MC, Leckman, JF, Mercadante, MTet al. Adults with early-onset obsessive-compulsive disorder. Am J Psychiatry 2001;158:1899–1903. CrossRefGoogle ScholarPubMed
Hantouche, EG, Angst, J, Demonfaucon, C, Perugi, G, Lancrenon, S, Akiskal, HS.Cyclothymic OCD: a distinct form? J Affect Disord 2003;75:1–10. CrossRefGoogle ScholarPubMed
Perugi̇, G, Toni̇, C, Frare, F, Travi̇erso, MC, Hantouche, MC, Aki̇skal, HS.Obsessive-compulsive-bipolar comorbidity: a systematic exploration of clinical features and treatment outcome. J Clin Psychiatry 2002;63:1129–1134. CrossRefGoogle ScholarPubMed
Berk, M, Koopowitz, LE, Szabo, CP.Antidepressant induced mania in OCD. Eur Neuropsychopharmacol 1996; 6:9–11. CrossRefGoogle Scholar
Boylan, KR, Bieling, PJ, Marriott, M, Begin, H, Young, LT, MacQueen, G.Impact of comorbid anxiety disorders on outcome in a cohort of patients with bipolar disorder. J Clin Psychiatry 2004;65:1106–1113. CrossRefGoogle Scholar
Masi̇, G, Perugi̇, G, Toni̇, Cet al. Obsessive-compulsive bipolar comorbidity: focus on children and adolescents. J Affect Disord 2004;78:175–183. CrossRefGoogle ScholarPubMed
Mi̇guel, EC, Leckman, JF, Rauch, Set al. Obsessive-compulsive disorder phenotypes: implications for genetic studies. Mol Psychiatry 2005;10:258–275. CrossRefGoogle ScholarPubMed
De Mathis, MA, Diniz, JB, Do Rosário, MCet al. What is the optimal way to subdivide obsessive-compulsive disorder? CNS Spectr 2006;11:762–768, 771–774, 776–779. CrossRefGoogle ScholarPubMed
Torres, AR, De Abreu Ramos-Cerqueira, AT, Torresan, RC, De Souza Domi̇ngues, M, Hercos, AC, Gui̇marães, AB.Prevalence and associated factors for suicidal ideation and behaviors in obsessive-compulsive disorder. CNS Spectr 2007;12:771–778. CrossRefGoogle ScholarPubMed
Kamath, P, Reddy, YC, Kandavel, T.Suicidal behavior in obsessive-compulsive disorder. J Clin Psychiatry 2007;68:1741–1750. CrossRefGoogle ScholarPubMed
Norton, PJ, Temple, SR, Petti̇t, JW.Suicidal ideation and anxiety disorders: elevated risk or artifact of comorbid depression? J Behav Ther Exp Psychiatry 2008;39:515–525. CrossRefGoogle ScholarPubMed
Bolton, JM, Cox, BJ, Afi̇fi̇, TO, Enns, MW, Bi̇envenu, OJ, Sareen, J.Anxiety disorders and risk for suicide attempts: findings from the Baltimore Epidemiologic Catchment area follow-up study. Depress Anxiety 2008;25:477–481. CrossRefGoogle ScholarPubMed
Taylor, CT, Hi̇rshfeld-Becker, DR, Ostacher, MJet al. Anxiety is associated with impulsivity in bipolar disorder. J Anxiety Disord 2008;22:868–876. CrossRefGoogle ScholarPubMed
Bi̇envenu, OJ, Samuels, JF, Ri̇ddle, MAet al. The relationship of obsessive-compulsive disorder to possible spectrum disorders: results from a family study. Biol Psychiatry 2000;48:287–293. CrossRefGoogle ScholarPubMed
Jacobsen, FM.Risperidone in the treatment of affective illness and obsessive-compulsive disorder. J Clin Psychiatry 1995;56:423–429. Google ScholarPubMed
Koran, LM, Ringold, AL, Elliott, MA.Olanzapine augmentation for treatment-resistant obsessive-compulsive disorder. J Clin Psychiatry 2000;61:514–517. CrossRefGoogle ScholarPubMed
Raja, M, Azzoni̇, A.Clinical management of obsessive-compulsive-bipolar comorbidity: a case series. Bipolar Disord 2004;6:264–270. CrossRefGoogle ScholarPubMed