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Bipolar disorder-OCD may be separate disease entity
By Andrew Czyzewski, MedWire News
06 April 2010
Acta Neuropsychiatrica 2010: 22: 81–86
Patients with bipolar disorder and comorbid obsessive-compulsive disorder (OCD) present with more depressive episodes and are at a greater risk for treatment-emergent mania than their peers with bipolar disorder alone, research shows.
As the comorbid patients also had a greater burden of anxiety and impulse control disorders the findings raise the possibility that this group represents a distinct disease entity.
A recent analysis of the US Epidemiological Catchment Area Study data set found that lifetime rates of OCD in patients with bipolar disorder and major depression were 21% and 12.2%, respectively.
“Although OCD-bipolar disorder comorbidity is now considered highly prevalent, very few controlled studies have examined the impact of comorbid OCD on the course and treatment of bipolar disorder,” Beny Lafer (University of S?o Paulo School of Medicine, Brazil) and colleagues comment in the journal Acta Neuropsychiatrica.
For the present study the researchers recruited 30 clinically stable female outpatients with bipolar disorder, divided into two groups: bipolar disorder-OCD, consisting of 15 patients; and bipolar disorder only, also 15 patients.
The groups were matched for age, ethnicity, education, and socioeconomic status.
Following structured clinical interview with the DSM-IV, Lafer and team found that the bipolar disorder-OCD patients presented with a greater number of previous depressive episodes, more chronic episodes, and more residual symptoms after an episode, than the bipolar disorder only patients.
Of the bipolar disorder-OCD patients, 86% had a history of treatment-emergent mania, compared with only 40% of the bipolar disorder only patients.
In addition patients with bipolar disorder-OCD showed a higher prevalence of several psychiatric disorders compared with the bipolar disorder only patients, including any anxiety disorder (93.3 vs 53.3%); impulse control disorders (60% vs 13.3%); eating disorders (33.3 vs 0%); and tic disorders (33.3 vs 0%).
“Although the data available are insufficient to allow us to define OCD-bipolar disorder comorbidity as a distinct entity, future research examining the familial-genetic and neurobiological aspects of this comorbidity will further the understanding of its exact nature,” Lafer and colleagues conclude
Source: Acta Neuropsychiatrica, Volume 22, Issue 2, Pages 81 - 86
By Andrew Czyzewski, MedWire News
06 April 2010
Acta Neuropsychiatrica 2010: 22: 81–86
Patients with bipolar disorder and comorbid obsessive-compulsive disorder (OCD) present with more depressive episodes and are at a greater risk for treatment-emergent mania than their peers with bipolar disorder alone, research shows.
As the comorbid patients also had a greater burden of anxiety and impulse control disorders the findings raise the possibility that this group represents a distinct disease entity.
A recent analysis of the US Epidemiological Catchment Area Study data set found that lifetime rates of OCD in patients with bipolar disorder and major depression were 21% and 12.2%, respectively.
“Although OCD-bipolar disorder comorbidity is now considered highly prevalent, very few controlled studies have examined the impact of comorbid OCD on the course and treatment of bipolar disorder,” Beny Lafer (University of S?o Paulo School of Medicine, Brazil) and colleagues comment in the journal Acta Neuropsychiatrica.
For the present study the researchers recruited 30 clinically stable female outpatients with bipolar disorder, divided into two groups: bipolar disorder-OCD, consisting of 15 patients; and bipolar disorder only, also 15 patients.
The groups were matched for age, ethnicity, education, and socioeconomic status.
Following structured clinical interview with the DSM-IV, Lafer and team found that the bipolar disorder-OCD patients presented with a greater number of previous depressive episodes, more chronic episodes, and more residual symptoms after an episode, than the bipolar disorder only patients.
Of the bipolar disorder-OCD patients, 86% had a history of treatment-emergent mania, compared with only 40% of the bipolar disorder only patients.
In addition patients with bipolar disorder-OCD showed a higher prevalence of several psychiatric disorders compared with the bipolar disorder only patients, including any anxiety disorder (93.3 vs 53.3%); impulse control disorders (60% vs 13.3%); eating disorders (33.3 vs 0%); and tic disorders (33.3 vs 0%).
“Although the data available are insufficient to allow us to define OCD-bipolar disorder comorbidity as a distinct entity, future research examining the familial-genetic and neurobiological aspects of this comorbidity will further the understanding of its exact nature,” Lafer and colleagues conclude
Source: Acta Neuropsychiatrica, Volume 22, Issue 2, Pages 81 - 86
