Bipolar Disorder (BD) and Obsessive Compulsive Disorder (OCD) Comorbidty or Varied Episodes in the Same Disorder

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
E. Oral ◽  
E. Ozan ◽  
E. Deveci ◽  
N. Aydın ◽  
I. Kirpinar
Keyword(s):  
Bipolar Disorder ◽  
Depressive Symptoms ◽  
Lithium Carbonate ◽  
Treatment Resistant ◽  
Obsessive Compulsive ◽  
Obsessive Compulsive Symptoms ◽  
Compulsive Disorder ◽  
Manic Symptoms ◽  
Episodic Course ◽  
Depressive Episodes

Previous studies have suggested that OCD has comorbidity with bipolar disorder (BD) (1,2). We evaluated the three bipolar OCD cases.C1: Because of the OCD symptoms Chlomipramine was started. Her OCD symptoms improved in several days but manic symptoms was apeeared, switched to Lithium Carbonate. In her out patient exams, manic and obsessive compulsive symptoms were almost never observed simultaneously at the course.C2: In 2003, her complaints started as combined OCD and Manic symptoms, Risperidon and Lithium carbonate were started, manic and OCD symptoms improved. In 2005, OCD and Depressive symptoms appeared together. She got improved with Lithium Carbonate and Chlomipramine. She had one episode with obsessive and manic symptoms or obsessive and depressive symptoms every year till now. Her uncle had Depression and her aunt had Bipolar disorder.C3: Because of his OCD symptoms we prescribed SSRI and lower dose antipsychotic. At that time he hospitalized for his manic symptoms, his OCD was partially remitted. His manic symptoms improved with Lithium carbonate1200p/d. He had resistant obsessive compulsive symptoms and episodic manic symptoms. His father had M. Depressive episodes.Conclusion:Our cases suggest that bipolar OCD has episodic course, treatment resistant symtomatology, high family loading and high frequency of recurrence.

Bipolar Disorder (BD) and Obsessive Compulsive Disorder (OCD) Comorbidty or Varied Episodes in the Same Disorder

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
E. Oral ◽  
E. Ozan ◽  
E. Deveci ◽  
N. Aydın ◽  
I. Kirpinar
Keyword(s):  
Bipolar Disorder ◽  
Depressive Symptoms ◽  
Lithium Carbonate ◽  
Treatment Resistant ◽  
Obsessive Compulsive ◽  
Obsessive Compulsive Symptoms ◽  
Compulsive Disorder ◽  
Manic Symptoms ◽  
Episodic Course ◽  
Depressive Episodes

Previous studies have suggested that OCD has comorbidity with bipolar disorder (BD) (1,2). We evaluated the three bipolar OCD cases.C1: Because of the OCD symptoms Chlomipramine was started. Her OCD symptoms improved in several days but manic symptoms was apeeared, switched to Lithium Carbonate. In her out patient exams, manic and obsessive compulsive symptoms were almost never observed simultaneously at the course.C2: In 2003, her complaints started as combined OCD and Manic symptoms, Risperidon and Lithium carbonate were started, manic and OCD symptoms improved. In 2005, OCD and Depressive symptoms appeared together. She got improved with Lithium Carbonate and Chlomipramine. She had one episode with obsessive and manic symptoms or obsessive and depressive symptoms every year till now. Her uncle had Depression and her aunt had Bipolar disorder.C3: Because of his OCD symptoms we prescribed SSRI and lower dose antipsychotic. At that time he hospitalized for his manic symptoms, his OCD was partially remitted. His manic symptoms improved with Lithium carbonate1200p/d. He had resistant obsessive compulsive symptoms and episodic manic symptoms. His father had M. Depressive episodes.Conclusion:Our cases suggest that bipolar OCD has episodic course, treatment resistant symtomatology, high family loading and high frequency of recurrence.

A comparison of the symptomatic profile between two consecutive depressive episodes in patients with bipolar disorder type I

2010 ◽  
Vol 22 (6) ◽  
pp. 280-283 ◽  
Author(s):  
Marcia B De Macedo-Soares ◽  
Elisa Brietzke ◽  
Rodrigo Da Silva Dias ◽  
Tiago Mendonça ◽  
Camila Moreira ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Depressive Symptoms ◽  
Rating Scale ◽  
Type I ◽  
Obsessive Compulsive ◽  
Obsessive Compulsive Symptoms ◽  
Paranoid Symptoms ◽  
Loss Of Appetite ◽  
Depressive Episodes ◽  
Disorder Type

de Macedo-Soares MB, Brietzke E, da Silva Dias R, Mendonca T, Moreira C, Lafer B. A comparison of the symptomatic profile between two consecutive depressive episodes in patients with bipolar disorder type I.Objective:To compare the variability of patterns of depressive symptoms between two consecutive depressive episodes in patients with bipolar disorder type I.Methods:Review of prospectively collected data from 136 subjects of an out-patient bipolar unit from 1997 to 2007. Binomial statistics was used for the analysis of Hamilton Depression Rating Scale (HDRS)-31 items of the first and second episodes, and the correlation of the HDRS-31 item scores of both episodes was determined using the Spearman coefficient.Results:Ten depressive symptoms showed a significant correlation between index and subsequent episodes: psychological anxiety, somatic anxiety, somatic symptoms, diurnal variation, paranoid symptoms, obsessive and compulsive symptoms, hypersomnia, loss of appetite and helplessness. Only four symptoms were stable in both statistical tests: paranoid symptoms, obsessive–compulsive symptoms, loss of appetite and hypersomnia.Conclusions:Paranoid and obsessive–compulsive symptoms, loss of appetite and hypersomnia tended to be found in successive episodes. However, the moderate correlations of the symptoms across two depressive recurrences suggested that clinical presentations in bipolar depression may not be predicted by symptom profiles presented in previous episodes.

Bipolar disorder and comorbid obsessive-compulsive disorder is associated with higher rates of anxiety and impulse control disorders

2010 ◽  
Vol 22 (2) ◽  
pp. 81-86 ◽  
Author(s):  
Cilly Klüger Issler ◽  
Emel Serap Monkul ◽  
José Antonio de Mello Siqueira Amaral ◽  
Renata Sayuri Tamada ◽  
Roseli Gedanke Shavitt ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Obsessive Compulsive Disorder ◽  
Impulse Control ◽  
Severe Form ◽  
Impulse Control Disorders ◽  
Tic Disorders ◽  
Obsessive Compulsive ◽  
Residual Symptoms ◽  
Compulsive Disorder ◽  
Depressive Episodes

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.

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

2019 ◽  
Vol 25 (41) ◽  
pp. 5722-5730 ◽  
Author(s):  
Federico Mucci ◽  
Cristina Toni ◽  
Ettore Favaretto ◽  
Giulia Vannucchi ◽  
Donatella Marazziti ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Clinical Features ◽  
Bipolar Disorders ◽  
Mood Stabilizers ◽  
Obsessive Compulsive ◽  
Therapeutic Implications ◽  
Compulsive Disorder ◽  
Episodic Course ◽  
The 19Th Century ◽  
Depressive Episodes

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.

scholarly journals Obsessive-Compulsive Symptoms as a Manifestation of Homocystinuria

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Vera Froes ◽  
Hugo Afonso ◽  
Zita Gameiro
Keyword(s):  
Plasma Levels ◽  
Metabolic Disorder ◽  
Autosomal Recessive ◽  
Psychiatric Symptoms ◽  
Psychiatric History ◽  
Treatment Resistant ◽  
Obsessive Compulsive ◽  
Obsessive Compulsive Symptoms ◽  
Compulsive Disorder ◽  
Lack Of Information

Homocystinuria is a rare autosomal recessive metabolic disorder due to a defect in the cystathionine β-synthase (CBS) that leads to high homocysteine plasma levels. Psychiatric symptoms secondary to homocystinuria have been described in the literature; however, there is a lack of information about obsessive-compulsive symptoms correlated to this disorder. We describe the case of a 39 years old man, diagnosed with homocystinuria in childhood, with no previous psychiatric history that presented obsessive-compulsive disorder (OCD) like symptoms, as a manifestation of homocystinuria. This case underlines the importance for a psychiatrist to explore medical nonpsychiatric history, especially when presentation is abrupt, atypical, or in treatment-resistant cases.

scholarly journals The Relationship of Meta-Worry and Intolerance of Uncertainty With Pathological Worry, Anxiety, and Depression

2011 ◽  
Vol 28 (4) ◽  
pp. 165-180 ◽  
Author(s):  
Nigar G. Khawaja ◽  
Janette McMahon
Keyword(s):  
Depressive Symptoms ◽  
Social Phobia ◽  
Obsessive Compulsive Disorder ◽  
Intolerance Of Uncertainty ◽  
Obsessive Compulsive ◽  
Obsessive Compulsive Symptoms ◽  
Compulsive Disorder ◽  
Assessment And Treatment ◽  
Pathological Worry ◽  
Relationship Of

AbstractThis study explored how meta-worry and intolerance of uncertainty relate to pathological worry, generalised anxiety, obsessive–compulsive disorder, social phobia, and depression. University students (n = 253)completed a questionnaire battery. A series of regression analyses were conducted. The results indicated that meta-worry was associated with GAD, social phobia, obsessive–compulsive, and depressive symptoms. Intolerance of uncertainty was related to GAD, social phobia, and obsessive–compulsive symptoms, but not depressive symptoms. The importance of meta-worry and intolerance of uncertainty as predictors of pathological worry, GAD, social phobia, obsessive–compulsive and depressive symptoms was also examined. Even though both factors significantly predicted the aforementioned symptoms, meta-worry emerged as a stronger predictor of GAD and obsessive compulsive symptoms than did intolerance of uncertainty. Intolerance of uncertainty, compared with meta-worry, appeared as a stronger predictor of social phobia symptoms. Findings emphasise the importance of addressing meta-worry and/or intolerance of uncertainty not only for the assessment and treatment of generalised anxiety disorder (GAD), but also obsessive–compulsive disorder, social phobia, and depression.

Cognitive–behavioural therapy augments the effects of deep brain stimulation in obsessive–compulsive disorder

2014 ◽  
Vol 44 (16) ◽  
pp. 3515-3522 ◽  
Author(s):  
M. Mantione ◽  
D. H. Nieman ◽  
M. Figee ◽  
D. Denys
Keyword(s):  
Depressive Symptoms ◽  
Deep Brain Stimulation ◽  
Nucleus Accumbens ◽  
Behavioural Therapy ◽  
Obsessive Compulsive ◽  
Obsessive Compulsive Symptoms ◽  
Compulsive Disorder ◽  
Cognitive Behavioural ◽  
Treatment Refractory ◽  
Deep Brain

Background.Deep brain stimulation (DBS) is a promising new treatment for patients with treatment-refractory obsessive–compulsive disorder (OCD). However, since most DBS patients only show a partial response, the treatment still needs to be improved. In this study we hypothesized that cognitive–behavioural therapy (CBT) could optimize the post-operative management in DBS and we evaluated the efficacy of CBT as augmentation to DBS targeted at the nucleus accumbens.Method.A total of 16 patients with treatment-refractory OCD were treated with DBS targeted at the nucleus accumbens. After stabilization of decline in OCD symptoms, a standardized 24-week CBT treatment programme was added to DBS in an open-phase trial of 8 months. Changes in obsessive–compulsive, anxiety and depressive symptoms were evaluated using the Yale–Brown Obsessive Compulsive Scale, Hamilton Anxiety Scale and Hamilton Rating Scale for Depression.Results.Following the addition of CBT to DBS, a significant decrease in obsessive–compulsive symptoms was observed, but not in anxiety and depressive symptoms. In a subsequent double-blind phase, in which stimulation was discontinued, OCD symptoms returned to baseline (relapse) and anxiety and depressive symptoms worsened (rebound) compared with baseline.Conclusions.The results of this explorative study suggest that a combined treatment of accumbens DBS and CBT may be optimal for improving obsessive–compulsive symptoms in treatment-refractory OCD. However, a subsequent randomized controlled trial is necessary to draw firm conclusions. It seems that DBS results in affective changes that may be required to enable response prevention in CBT. This may indicate that DBS and CBT act as two complementary treatments.

Methylphenidate-Induced Obsessive-Compulsive Symptoms in an Elderly Man

CNS Spectrums ◽  
2003 ◽  
Vol 8 (8) ◽  
pp. 612-613 ◽  
Author(s):  
Michael Serby
Keyword(s):  
Psychiatric History ◽  
Compulsive Behavior ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Obsessive Compulsive ◽  
Obsessive Compulsive Symptoms ◽  
Compulsive Disorder ◽  
Resistant Depression ◽  
Early Alzheimer’S Disease ◽  
Pathological Behavior

ABSTRACTAn 82-year-old man with treatment-resistant depression and early Alzheimer's disease was started on methylphenidate. Significant obsessive-compulsive behavior ensued but diminished over several weeks when methylphenidate was replaced by fluvoxamine. The patient had no prior psychiatric history, but he had a sister with obsessive-compulsive disorder. It appears that methylphenidate precipitated the patient's pathological behavior.

scholarly journals Specialised in-patient treatment for severe, chronic, resistant obsessive–compulsive disorder

2007 ◽  
Vol 31 (2) ◽  
pp. 49-52 ◽  
Author(s):  
Lynne M. Drummond ◽  
Anusha Pillay ◽  
Peter Kolb ◽  
Shashi Rani
Keyword(s):  
Depressive Symptoms ◽  
Obsessive Compulsive Disorder ◽  
Self Report ◽  
Patient Treatment ◽  
Clinical Implications ◽  
Naturalistic Study ◽  
Obsessive Compulsive ◽  
Obsessive Compulsive Symptoms ◽  
Compulsive Disorder ◽  
The Mean

Aims and MethodA naturalistic study was conducted to examine the outcome on self-report and observer-rated measures in patients with severe, chronic, resistant obsessive–compulsive disorder (OCD) admitted to a specialised in-patient unit.ResultsTwenty-six patients were admitted over the study period. The mean age of all patients was 37 years (s.d.=13.8, range 18–61 years) and they had a mean duration of OCD of 18.4 years (s.d.=10.9, range 4–40 years). Instruments measuring severity demonstrated a 37–67% reduction in obsessive–compulsive symptoms and a 64% reduction in depressive symptoms after an average of almost 15 weeks in hospital.Clinical ImplicationsThis study demonstrates that specialised in-patient care can benefit a small group of severely ill patients with OCD who fail to respond to treatment in primary and secondary care.

scholarly journals Clinical and familial profile of bipolar disorder with and without obsessive-compulsive disorder: an Indian study

2017 ◽  
Vol 39 (4) ◽  
pp. 270-275 ◽  
Author(s):  
Firoz Kazhungil ◽  
Ajitha Cholakottil ◽  
Shihab Kattukulathil ◽  
Abdurazak Kottelassal ◽  
Rajeesh Vazhakalayil
Keyword(s):  
Bipolar Disorder ◽  
Obsessive Compulsive Disorder ◽  
Rating Scale ◽  
Obsessive Compulsive ◽  
Young Mania ◽  
Chi Square ◽  
Compulsive Disorder ◽  
Chi Square Test ◽  
Axis I ◽  
Depressive Episodes

Abstract Introduction Comorbid obsessive-compulsive disorder (OCD) is common in bipolar disorder (BD). Clinical characteristics, functionality and familial pattern of this comorbidity are largely understudied. Objective To assess clinical profile, familial loading of psychiatric disorders and level of functioning in remitted BD patients who have comorbid OCD and to compare results with those of remitted BD patients without OCD. Methods Remitted BD-I subjects were assessed using the Structured Clinical Interview for DSM-IV Axis I Disorders, Global Assessment of Functioning Scale (GAF), Hamilton Depression Rating Scale (HDRS), Young Mania Rating Scale (YMRS), Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and Family Interview for Genetic Studies (FIGS). BD patients with and without OCD were compared. Group differences were analyzed using the chi-square test and the independent samples t test. Values <0.05 were considered statistically significant. Results Of the 90 remitted BD-I patients, 35.5% (n=32) had obsessive-compulsive symptoms/OCD. The BD-OCD group showed significantly lower GAF scores, higher rates of suicidal attempts, hospitalizations, manic and depressive episodes compared to the group with BD only (p<0.05). In addition, first and second-degree relatives had higher rates of BD-OCD and OCD, but not of BD. Conclusions BD-OCD is characterized by more severe BD, more dysfunction and higher familial loading of BD-OCD and OCD. Larger studies involving relatives of probands will help to confirm our findings and to delineate nosological status of BD-OCD comorbidity.

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