Co-morbid anxiety disorders in bipolar disorder and major depression: familial aggregation and clinical characteristics of co-morbid panic disorder, social phobia, specific phobia and obsessive-compulsive disorder

Goes, Fernando S.; McCusker, Michael G.; Bienvenu, O. Joseph; MacKinnon, Dean F.; Mondimore, Francis M.; Schweizer, Barbara; DePaulo, J. Raymond; Potash, James B.

doi:10.1017/s0033291711002637

Cited by 112 publications

(76 citation statements)

References 53 publications

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“…In the ECA database, OCD-BD patients had statistically significant higher lifetime rates of 'thoughts of suicide', 'suicide attempts', 'thoughts of death', and 'wanting to die' vs. non-OCD-BD patients (3). These features were confirmed in most recent studies both in OCD-BD patients (31,37,39,75) and in BD-OC syndrome patients (16). OCD also was associated with a 2.4-fold increase in the odds of suicidal ideation among BD adolescents as compared to noncomorbid adolescents (45).…”

Section: Included Studiessupporting

confidence: 80%

“…In other studies, most BD-OCD subjects either had OCD confined exclusively to depressive episodes or reported worsening of OCD during depression (64); one report showed that in 44% of BD-OCD patients, BD and OCD cycled together (29). When assessed, the total number of depressive episodes was higher in patients with OCD-BD comorbidity than in BD alone (74,75).…”

Section: Included Studiesmentioning

confidence: 92%

“…associated with a 2.4-fold increase in the odds of suicidal ideation vs. non-OCD-BD pt. (95% CI = 1.0-5.8) Goes et al 2012 (75) Higher rates of history of suicide attempts in OCD-BD pt. vs. non-OCD-BD pt.…”

Section: Included Studiesmentioning

confidence: 99%

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Diagnostic validity of comorbid bipolar disorder and obsessive–compulsive disorder: a systematic review

Amerio

Odone

Liapis

et al. 2014

Acta Psychiatr Scand

107

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Diagnostic validity of comorbid bipolar disorder and obsessive-compulsive disorder: a systematic review Amerio A, Odone A, Liapis CC, Ghaemi SN. Diagnostic validity of comorbid bipolar disorder and obsessive-compulsive disorder: a systematic review.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 AE 4.2 vs. 4.1 AE 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. • The evidence so far on BD-OCD nosology-mainly based on the course of illness-supports the view that the majority of cases of comorbid BD-OCD are in fact cases of BD. OC symptoms usually are secondary manifestations of depressive or manic mood episodes.• BD-OCD patients may respond for both groups of symptoms with adequate doses of mood stabilizers and atypical antipsychotics. Because of the risk of worsening BD via SRI-induced mania/hypomania, antidepressants should only be used in a minority of refractory OCD. Considerations• Course of illness is the only diagnostic validator that clearly supports the OCD-BD construct as a subtype of BD. Findings on the phenomenology, heredity, biological markers, and treatment were fragmented and heterogeneous and mainly suggested increased severity of illness or functioning without helping us to answer the nosological question.• The use of retrospective assessment scales with unclear sensitivity in discriminating true ego-dystonic obsessions from depressive ruminations may have biased results toward an overestimation of obsession's prevalence. In addition, small sample sizes, mainly from out-patients units, may have limited the generalizability of the results to a whole community.

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Section: Included Studiessupporting

confidence: 80%

Section: Included Studiesmentioning

confidence: 92%

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Diagnostic validity of comorbid bipolar disorder and obsessive–compulsive disorder: a systematic review

Amerio

Odone

Liapis

et al. 2014

Acta Psychiatr Scand

107

View full text Add to dashboard Cite

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“…It is noteworthy that the FST is a test that is used widely because of its predictive validity, as it is sensitive to all classes of antidepressant drugs (Borsini & Meli, 1988;Deussing, 2006;Lucki, 1997). In addition, as anxiety is present in the majority of patients with depressive disorder (Fava et al, 2000;Goes et al, 2012), it is well known that antidepressant drugs can also ameliorate anxiety-like depression symptoms. Thus, we also explored anxiolytic-like effects using the EPM as a primary screening test, as well as depressive animal models.…”

Section: Discussionmentioning

confidence: 99%

Involvement of norepinephrine and serotonin system in antidepressant-like effects of hederagenin in the rat model of unpredictable chronic mild stress-induced depression

Liang

Huang

Wang

et al. 2014

Pharmaceutical Biology

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Objective: This study compared the antidepressant ability of FAE with that of HG in mice and further investigated the antidepressant-like effects and potential mechanisms of HG in rats subjected to unpredictable chronic mild stress (UCMS). Materials and methods: Mice received FAE (50 mg/kg) and HG (20 mg/kg) once a day via intragastric administration (i.g.) for 3 weeks. The anxiolytic and antidepressant activities of FAE and HG were compared using elevated plus maze (EPM) and behavioral despair tests including tail suspension test (TST) and forced swimming test (FST), respectively. Antidepressant effects of HG (5 mg/kg) were assessed using the UCMS depressive rat model. Moreover, the levels of monoamine neurotransmitters and relevant gene expression in UCMS rats' hippocampi were determined through high-performance liquid chromatography with electrochemical detection and real-time polymerase chain reaction techniques. Results: The results of our preliminary screening test suggest that HG at 20 mg/kg, while not FAE at 50 mg/kg, significantly decreased the immobility in both TST and FST compared with the vehicle group when administered chronically; however, there were no significant differences observed between the HG and the FAE group. Chronic administration of HG failed to significantly reverse the altered crossing and rearing behavioral performance, time spent in the open arm and closed entries in the EPM, even if they showed an increased tendency, but HG significantly increased the percent of sucrose preference in the sucrose preference test (SPT) and decreased the immobility time in the FST. HG showed that significant increases of norepinephrine and serotonin levels and exhibited a tendency to increase the expression of 5-hydroxytryptamine (serotonin) 1A receptor mRNA, and to significantly decrease the expression of the mRNA for the serotonin transporter (5-HTT). However, there were no significant differences in the expression of the brain-derived neurotrophic factor. Conclusion: These findings confirm the antidepressant-like effects of HG in a behavioral despair test and UCMS rat model, which may be associated with monoamine neurotransmitters and 5-HTT mRNA expression.

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“…When diagnosed comorbidly with BD, OCD has been associated with an earlier onset of BD, a higher number of previous mood episodes, rapid cycling, seasonality, substance misuse, and lower overall functioning 732, 737, 738, 739, 740, 741, 742. Jeon et al recently conducted a comprehensive review of patients diagnosed with BD and comorbid OCD and found twice the rate of pharmacological switch to mania or hypomania, but suggested this could be due to the more frequent use of antidepressants in that population 732.…”

Section: Specific Populationsmentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

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The Canadian Network for Mood and Anxiety Treatments (CANMAT) previously published treatment guidelines for bipolar disorder in 2005, along with international commentaries and subsequent updates in 2007, 2009, and 2013. The last two updates were published in collaboration with the International Society for Bipolar Disorders (ISBD). These 2018 CANMAT and ISBD Bipolar Treatment Guidelines represent the significant advances in the field since the last full edition was published in 2005, including updates to diagnosis and management as well as new research into pharmacological and psychological treatments. These advances have been translated into clear and easy to use recommendations for first, second, and third‐ line treatments, with consideration given to levels of evidence for efficacy, clinical support based on experience, and consensus ratings of safety, tolerability, and treatment‐emergent switch risk. New to these guidelines, hierarchical rankings were created for first and second‐ line treatments recommended for acute mania, acute depression, and maintenance treatment in bipolar I disorder. Created by considering the impact of each treatment across all phases of illness, this hierarchy will further assist clinicians in making evidence‐based treatment decisions. Lithium, quetiapine, divalproex, asenapine, aripiprazole, paliperidone, risperidone, and cariprazine alone or in combination are recommended as first‐line treatments for acute mania. First‐line options for bipolar I depression include quetiapine, lurasidone plus lithium or divalproex, lithium, lamotrigine, lurasidone, or adjunctive lamotrigine. While medications that have been shown to be effective for the acute phase should generally be continued for the maintenance phase in bipolar I disorder, there are some exceptions (such as with antidepressants); and available data suggest that lithium, quetiapine, divalproex, lamotrigine, asenapine, and aripiprazole monotherapy or combination treatments should be considered first‐line for those initiating or switching treatment during the maintenance phase. In addition to addressing issues in bipolar I disorder, these guidelines also provide an overview of, and recommendations for, clinical management of bipolar II disorder, as well as advice on specific populations, such as women at various stages of the reproductive cycle, children and adolescents, and older adults. There are also discussions on the impact of specific psychiatric and medical comorbidities such as substance use, anxiety, and metabolic disorders. Finally, an overview of issues related to safety and monitoring is provided. The CANMAT and ISBD groups hope that these guidelines become a valuable tool for practitioners across the globe.

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Co-morbid anxiety disorders in bipolar disorder and major depression: familial aggregation and clinical characteristics of co-morbid panic disorder, social phobia, specific phobia and obsessive-compulsive disorder

Cited by 112 publications

References 53 publications

Diagnostic validity of comorbid bipolar disorder and obsessive–compulsive disorder: a systematic review

Diagnostic validity of comorbid bipolar disorder and obsessive–compulsive disorder: a systematic review

Involvement of norepinephrine and serotonin system in antidepressant-like effects of hederagenin in the rat model of unpredictable chronic mild stress-induced depression

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

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