Obsessive-compulsive Disorder with Comorbid Bipolar Disorders: Clinical Features and Treatment Implications

Abstract

Background: Obsessive-compulsive disorder (OCD) symptoms within the context of a bipolar disorder (BD) have been described since the 19th century. Interestingly, the existence of a relevant overlap between the aforementioned psychiatric syndromes has been confirmed by a number of recent epidemiological and family studies.

Aims: The aim of the present paper is to review the clinical features and the therapeutic implications of the OCD-BD comorbidity.

Discussion: In the last two decades, the frequent association between OCD and BD has been earning a growing interest given its relevant nosological and therapeutic implications. Usually patients suffering from OCD-BD comorbidity show a peculiar clinical course, characterized by a larger number of concomitant depressive episodes and episodic course. In these cases, the treatment with antidepressants is more likely to elicit hypomanic or manic switches, while mood stabilizers significantly improve the overall clinical picture. Moreover, OCD-BD patients are frequently comorbid with a number of other psychiatric disorders, in particular anxiety disorders, social phobia, and different substance abuses, such as alcohol, nicotine, caffeine and sedatives.

Conclusions: BD-OCD comorbidity needs further investigations in order to provide more solid evidences to give patients a more precise clinical diagnosis and a more targeted therapeutic approach.

Keywords: Obsessive-compulsive disorder; antidepressants; atypical antipsychotics; bipolar disorder; mood stabilizers; psychiatric comorbidity..