A Naturalistic Exploratory Study of Obsessive-Compulsive Bipolar Comorbidity in Youth

Masi, Gabriele; Berloffa, Stefano; Mucci, María; Pfanner, Chiara; D’Acunto, Giulia; Lenzi, Francesca; Liboni, Francesca; Manfredi, Azzurra; Milone, Annarita

doi:10.1016/j.jad.2018.01.020

Cited by 20 publications

(30 citation statements)

References 25 publications

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“…The results suggest that screening people with OCD for symptoms of hypomania is crucial, as the comorbidity represents an important marker of severity and risk of impairment. The fact that longitudinal clinical studies have also found that the presence of hypomanic symptoms (including subthreshold symptoms) is a predictor of treatment response (45)(46)(47) adds strength to the argument.…”

Section: Discussionmentioning

confidence: 98%

The Burden of Comorbidity Between Bipolar Spectrum and Obsessive-Compulsive Disorder in an Italian Community Survey

et al. 2020

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Background: The impact of the comorbidity between Obsessive-Compulsive Disorder (OCD) and Bipolar Disorder Spectrum (BDS) remains to be clarified. The objective of this study was to examine the lifetime prevalence of OCD, the strength of the association of OCD with comorbid BDS and the role of comorbidity of OCD with BDS in the impairment of health-related quality of life (HRQoL) in an Italian community survey. Methods: The study is a community survey. The sample (N = 2,267; women: 55.3%) was randomly selected after stratification by sex and four age groups from the municipal records of the adult population of one urban, one suburban, and at least one rural area in six Italian regions. Physicians using a semi-structured interview (Advanced Tools and Neuropsychiatric Assessment Schedule, ANTAS-SCID) made Diagnostic and Statistical Manual of Mental Disorders-4th revision (DSM-IV) diagnoses of OCD, Major Depressive Disorder (MDD) and Bipolar Disorder (BD). HR-QoL was measured by the Health Survey Short Form (SF-12). Lifetime Hypomania and subthreshold hypomania were screened by the Mood Disorder Questionnaire (MDQ). BDS was defined as the sum of people shown to be positive for hypomania by the MDQ-with or without a mood disorder diagnosis-plus people with a BD-DSMIV diagnosis even if negative for hypomania at the MDQ. Results: Overall, 44 subjects were diagnosed with OCD, 6 with MDD and 1 with BD. The lifetime prevalence of OCD was 1.8% in men (n = 18) and 2.0% in women (n = 26). MDD with lifetime subthreshold hypomania (i.e., people screened positive at the MDQ, even without diagnosed mania or hypomania at the interview) was associated with OCD (OR = 18.15, CI 95% 2.45-103.67); MDD without subthreshold hypomania (and screened negative at the MDQ) was not (OR = 2.33, CI 95% 0.69-7.01). People with BDS Carta et al. Bipolar Spectrum and Obsessive-Compulsive Disorders were strongly associated with OCD (OR = 10.5, CI 95% 4.90-12.16,). People with OCD and BDS showed significantly poorer HR-QoL than people with OCD without BDS (F = 9.492; P < 0.003). Discussion: The study found a strong association between BDS and OCD. BDS comorbid with OCD was associated with more severe impairment of HR-QoL than OCD without comorbid BDS. Identification of symptoms of hypomania, including subthreshold symptoms, may therefore be important in people with OCD as they might predict a course with poorer HR-QoL.

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Section: Discussionmentioning

confidence: 98%

The Burden of Comorbidity Between Bipolar Spectrum and Obsessive-Compulsive Disorder in an Italian Community Survey

et al. 2020

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“…8 The management implications for this group is that it has poorest treatment outcomes. 9 Lastly, treatment with antipsychotic agents especially those with anti-serotonergic profile such as second generation antipsychotic (SGA) like clozapine and risperidone have been hypothesized to be responsible for induction of obsessive symptoms. 10 The index case has also received risperidone as well as other SGAs for significant duration which could have possibly influenced the sexual and aggressive obsessions.…”

Section: Discussionmentioning

confidence: 99%

Transvestic Disorder, Obsessive Compulsive Disorder, and Bipolar Disorder in an Adolescent Male: Diagnostic Conundrums and Management Difficulties

Panda

Aneja

Swami

2021

Journal of Psychosexual Health

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Transvestic disorder with comorbid obsessive-compulsive disorder and bipolar disorder (BD) is a rare presentation, with only 1 case report in available literature. It may be an arduous task to differentiate between the phenomenology of transvestic disorder and obsessive-compulsive disorder. We, herein, report the case of a 17-year-old boy who presented with complaints of cross-dressing which was difficult to be differentiated from sexual obsessions. He also suffered from BD that complicated the management.

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“…9 Other studies specifically assessed the clinical characteristics of primary OCD patients with vs without BD comorbidity, reporting that comorbid patients present a worse clinical prognosis compared with noncomorbid patients, being associated with a higher suicidal risk, 15 more frequent hospitalizations, 16,17 more severe obsessive-compulsive symptoms according to Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score, 17 and a poorer response to treatments in a youth OCD sample. 18 Moreover, an additional comorbid disease has been reported more frequently in these patients, in particular with alcohol 19 and substance abuse, 17 and anxiety disorders. 17,19 In light of the above, the aim of the present study was to assess rates and clinical correlates of BD comorbidity in a large, international sample of primary OCD patients, recruited in centers affiliated with the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS).…”

Section: Introductionmentioning

confidence: 94%

Lifetime bipolar disorder comorbidity and related clinical characteristics in patients with primary obsessive compulsive disorder: a report from the International College of Obsessive–Compulsive Spectrum Disorders (ICOCS)

et al. 2019

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Introduction.Bipolar disorder (BD) and obsessive compulsive disorder (OCD) are prevalent, comorbid, and disabling conditions, often characterized by early onset and chronic course. When comorbid, OCD and BD can determine a more pernicious course of illness, posing therapeutic challenges for clinicians. Available reports on prevalence and clinical characteristics of comorbidity between BD and OCD showed mixed results, likely depending on the primary diagnosis of analyzed samples.Methods.We assessed prevalence and clinical characteristics of BD comorbidity in a large international sample of patients with primary OCD (n = 401), through the International College of Obsessive–Compulsive Spectrum Disorders (ICOCS) snapshot database, by comparing OCD subjects with vs without BD comorbidity.Results.Among primary OCD patients, 6.2% showed comorbidity with BD. OCD patients with vs without BD comorbidity more frequently had a previous hospitalization (p < 0.001) and current augmentation therapies (p < 0.001). They also showed greater severity of OCD (p < 0.001), as measured by the Yale–Brown Obsessive Compulsive Scale (Y-BOCS).Conclusion.These findings from a large international sample indicate that approximately 1 out of 16 patients with primary OCD may additionally have BD comorbidity along with other specific clinical characteristics, including more frequent previous hospitalizations, more complex therapeutic regimens, and a greater severity of OCD. Prospective international studies are needed to confirm our findings.

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A Naturalistic Exploratory Study of Obsessive-Compulsive Bipolar Comorbidity in Youth

Cited by 20 publications

References 25 publications

The Burden of Comorbidity Between Bipolar Spectrum and Obsessive-Compulsive Disorder in an Italian Community Survey

The Burden of Comorbidity Between Bipolar Spectrum and Obsessive-Compulsive Disorder in an Italian Community Survey

Transvestic Disorder, Obsessive Compulsive Disorder, and Bipolar Disorder in an Adolescent Male: Diagnostic Conundrums and Management Difficulties

Lifetime bipolar disorder comorbidity and related clinical characteristics in patients with primary obsessive compulsive disorder: a report from the International College of Obsessive–Compulsive Spectrum Disorders (ICOCS)

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