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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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