scholarly journals Aripiprazole augmentation in treating comorbid bipolar disorder and obsessive-compulsive disorder

2018 ◽  
Vol 31 (3) ◽  
pp. e100007 ◽  
Author(s):  
Andrea Amerio ◽  
Anna Odone

Obsessive-compulsive disorder (OCD) is one of the most difficult additional diagnoses to manage in patients with bipolar disorder (BD) since the gold standard treatment for one disease (antidepressants for OCD) can worsen the other. This case report describes the efficacy of aripiprazole augmentation as maintenance therapy in a young patient with comorbid BD-OCD. Our patient presented complete remission of affective and obsessive-compulsive symptoms with remarkable improvement in social and occupational functioning for 24 months. Adverse drug reactions were not severe enough to result in drug discontinuation. In consideration of the important nosological, clinical and therapeutic implications, future research efforts may lead to more grounded guidelines, which are greatly needed in patients with comorbid BD-OCD.

2005 ◽  
Vol 27 (2) ◽  
pp. 139-142 ◽  
Author(s):  
Cilly Klüger Issler ◽  
José Antonio de Mello Siqueira Amaral ◽  
Renata Sayuri Tamada ◽  
Angela Maria Schwartzmann ◽  
Roseli Gedanke Shavitt ◽  
...  

OBJECTIVE: To study clinical and psychopathological features of obsessive-compulsive disorder (OCD) in women with bipolar disorder (BD). METHODS: Fifteen outpatients with concurrent bipolar disorder I (80.0%) or II (20.0%) and obsessive-compulsive disorder were studied. Most of them (80.0%) sought treatment for bipolar disorder. They were ascertained by means of the Structured Clinical Interview for DSM-IV (SCID/P), semi-structured interviews to investigate obsessions, compulsions and sensory phenomena that may precede compulsions and an additional module for the diagnosis of chronic motor and vocal tics. Severity of symptoms was assessed by the Yale-Brown Obsessive-Compulsive Rating Scale, Hamilton Depression Rating Scale and Young Mania Rating Scale. RESULTS: Obsessive-compulsive disorder presented early onset (before the age of 10) in 9 (60%) cases, preceded bipolar disorder in 10 (66.7%) and displayed chronic waxing and waning course in 13 (86.7%) of them. There was wide overlap between types of obsessive-compulsive symptoms and all patients experienced sensory phenomena preceding the compulsions. There was no clear-cut impact of depressive and manic episodes on the intensity of obsessive-compulsive symptoms, which increased in depression and decreased in mania in 40.0% of the cases, had the opposite pattern in 26.7% of the patients and fluctuated inconsistently in the rest of them. Tics disorders were diagnosed in 5 (33.3%) patients. CONCLUSIONS: Our results suggest that in women with comorbid bipolar disorder and obsessive-compulsive disorder the latter presents features that may be typical of the association of the two disorders, such as early onset and sensory phenomena preceding compulsions. A prospective controlled study is necessary to confirm these observations, due to some limitations of our study: small exclusively female sample, heterogeneity concerning the type of bipolar disorder and the disorder that determined sought of treatment and retrospective non-controlled design.


Author(s):  
Edmund T. Rolls

The book will be valuable for those in the fields of neuroscience, neurology, psychology, psychiatry, biology, animal behaviour, economics, and philosophy, from the undergraduate level upwards. The book is unique in providing a coherent multidisciplinary approach to understanding the functions of one of the most interesting regions of the human brain, in both health and in disease, including depression, bipolar disorder, autism, and obsessive-compulsive disorder. There is no competing book published in the last 10 years.


Author(s):  
Jordana Muroff ◽  
Abigail Ross ◽  
Joseph Rothfarb

While cognitive-behavioral therapy (CBT) and pharmacotherapy are “gold standard” treatments for obsessive-compulsive disorder (OCD), complementary and alternative treatments are frequently sought for anxiety disorders. The purpose of this chapter is to review and discuss the available research on the application, efficacy and effectiveness of complementary and alternative methods for treating OCD. The first section identifies and reviews studies focusing on specific alternative and complementary treatments that are independent from, or work in conjunction with CBT, such as yoga, herbal remedies, motivational strategies, and bibliotherapy. The second section discusses alternative and complementary methods of more mainstream CBT and related techniques, with a particular focus on technology-supported approaches. The chapter concludes with a discussion of the methodological issues in the existing research on complementary and alternative methods in the treatment of OCD, questions for future research, and implications for providers.


2010 ◽  
Vol 4 (1) ◽  
pp. 16-29 ◽  
Author(s):  
Danielle A. Einstein ◽  
Ross G. Menzies ◽  
Tamsen St Clare ◽  
Juliette Drobny ◽  
Fjola Dogg Helgadottir

AbstractData collected from clinical populations indicate that magical ideation (MI) may play a causal or a mediating role in the expression of obsessive compulsive symptoms. If this is the case then when targeted in treatment, symptoms of obsessive compulsive disorder (OCD) should be altered. Two individuals diagnosed with OCD received a trial treatment targeting magical thinking. The intervention consisted of a series of procedures designed to undermine superstitious/MI without targeting obsessions or compulsions. The procedures involved critical analysis of the following material: (1) a free astrology offer; (2) a horoscope prediction exercise; (3) a description of four different cultural explanations of the origin of fire; (4) an instructive guide for Tarot card readers; (5) a report of a UFO sighting; (6) a video-clip describing a cult festival; (7) a description of a ‘hoax’ channeler and (8) a superstition exercise. Measures of obsessive compulsive symptoms, superstition, MI and thought–action fusion were administered pre-treatment, post-treatment and at 3 months’ follow-up. According to the twofold criterion of Jacobson et al. (Behaviour Therapy 1984, 15, 336–352), following treatment the patients were identified as being recovered on measures of magical and superstitious thinking and on the Padua Inventory.


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 ◽  
...  

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.


CNS Spectrums ◽  
2004 ◽  
Vol 9 (8) ◽  
pp. 607-612 ◽  
Author(s):  
Carlos Cruz-Fuentes ◽  
Claudia Blas ◽  
Laura Gonzalez ◽  
Beatriz Camarena ◽  
Humberto Nicolini

ABSTRACT:Objective:The present study examined the psychobiological Temperament and Character model of personality on obsessive-compulsive disorder (OCD) patients, as well as the relation of temperament and/or character dimensions on the severity of obsessive-compubive symptoms.Methods:Fifty-four subjects diagnosed with OCD, were assessed with the Temperament and Character Inventory, the Yale-Brown Obsessive-Compulsive scale and the Hamilton Rating Scales for depression and anxiety.Results:Compared with controls, OCD subjects displayed increased harm avoidance and lower self-directedness and cooperativeness. Low self-directedness and high Hamilton depression scores were associated with increased severity of obsessive-compulsive symptoms.Conclusions:The Temperament and Character profile of OCD patients characterized in the present stud personality model and can be linked to some of their behavioral features. Furthermore, our data provides support of the influence that some personality traits may have on the severity of OCD symptoms.


2006 ◽  
Vol 94 (1-3) ◽  
pp. 151-156 ◽  
Author(s):  
A PASHINIAN ◽  
S FARAGIAN ◽  
A LEVI ◽  
M YEGHIYAN ◽  
K GASPARYAN ◽  
...  

2014 ◽  
Vol 16 (2) ◽  
pp. 239-254 ◽  

The purpose of the article was to provide an overview of patient-reported outcomes (PROs) and related measures that have been examined in the context of obsessive-compulsive disorder (OCD). The current review focused on patient-reported outcome measures (PROMs) that evaluated three broad outcome domains: functioning, health-related quality of life (HRQoL), and OCD-related symptoms. The present review ultimately included a total of 155 unique articles and 22 PROMs. An examination of the PROs revealed that OCD patients tend to suffer from significant functional disability, and report lower HRQoL than controls. OCD patients report greater symptom severity than patients with other mental disorders and evidence indicates that PROMs are sensitive to change and may be even better than clinician-rated measures at predicting treatment outcomes. Nonetheless, it should be noted that the measures reviewed lacked patient input in their development. Future research on PROMs must involve patient perspectives and include rigorous psychometric evaluation of these measures.


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