The Co-Occurrence of Mania with Medical and other Psychiatric Disorders

Objective: The co-occurrence of mania with other medical and psychiatric disorders has been little studied. The authors reviewed the literature in order to clarify the current state of knowledge of this subject and to identify possible areas of future research. Methods: Published articles which specifically addressed associations of mania with medical disorders and other psychiatric syndromes were identified using the Paperchase® medical literature search system and by cross-referencing from other published work. The articles were then organized into three categories: 1) medical disorders associated with secondary mania; 2) medical comorbidity in bipolar disorder; and 3) psychiatric comorbidity in bipolar disorder. Results: The review of medical illness and secondary mania supports the hypothesis that injuries involving right-side and mid-line brain structures are associated with so-called secondary mania. Additionally, an association between bipolar disorder and migraine is identified. Several psychiatric disorders appear to occur with mania at rates higher than expected including obsessive-compulsive disorder, bulimia nervosa, panic disorder, impulse control disorders, and substance abuse. Conclusions: The authors discuss the potential implications of these findings and suggest research approaches to further examine the relationships between mania and other medical and psychiatric syndromes.

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Testing structural models of psychopathology at the genomic level

10.1101/502039 ◽

2018 ◽

Cited By ~ 1

Author(s):

Irwin D. Waldman ◽

Holly E. Poore ◽

Justin M. Luningham ◽

Jingjing Yang

Keyword(s):

Bipolar Disorder ◽

Eating Disorders ◽

Psychiatric Disorders ◽

Genetic Correlations ◽

Structural Models ◽

Higher Order ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Best Fitting ◽

Fitting Model

Genome-wide association studies (GWAS) have revealed hundreds of genetic loci associated with the vulnerability to major psychiatric disorders, and post-GWAS analyses have shown substantial genetic correlations among these disorders. This evidence supports the existence of a higher-order structure of psychopathology at both the genetic and phenotypic levels. Despite recent efforts by collaborative consortia such as the Hierarchical Taxonomy of Psychopathology (HiTOP), this structure remains unclear. In this study, we tested multiple alternative structural models of psychopathology at the genomic level, using the genetic correlations among fourteen psychiatric disorders and related psychological traits estimated from GWAS summary statistics. The best-fitting model included four correlated higher-order factors – externalizing, internalizing, thought problems, and neurodevelopmental disorders – which showed distinct patterns of genetic correlations with external validity variables and accounted for substantial genetic variance in their constituent disorders. A bifactor model including a general factor of psychopathology as well as the four specific factors fit worse than the above model. Several model modifications were tested to explore the placement of some disorders – such as bipolar disorder, obsessive-compulsive disorder, and eating disorders – within the broader psychopathology structure. The best-fitting model indicated that eating disorders and obsessive-compulsive disorder, on the one hand, and bipolar disorder and schizophrenia, on the other, load together on the same thought problems factor. These findings provide support for several of the HiTOP higher-order dimensions and suggest a similar structure of psychopathology at the genomic and phenotypic levels.

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P02 - 369 - Neuroimaging of the various symptom dimensions in obsessive - compulsive disorder - a systematic review

European Psychiatry ◽

10.1016/s0924-9338(11)72670-0 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 965-965

Author(s):

M. Dold ◽

R. Lanzenberger ◽

M. Aigner

Keyword(s):

Clinical Picture ◽

Brain Structures ◽

Anterior Cingulate ◽

Neural Representation ◽

Future Research ◽

Research Strategies ◽

Obsessive Compulsive ◽

Symptom Dimensions ◽

Compulsive Disorder ◽

Obsessive Compulsive Disorders

IntroductionSeveral neuroimaging studies in obsessive-compulsive disorders (OCD) have shown a dysfunction in the orbito-fronto-striato-thalamamic neural circuitry as the fundamental neuropathological correlate, consistent across all symptom subtypes.Therefore, the neurobiological differentiation of the various obsessive-compulsive symptoms is attracting increasing interest in neuroimaging as this clinical picture becomes increasingly subclassified.MethodA systematic literature survey was used to search for original papers that studied the neurobiological correlates of the various symptom dimensions of OCD (symmetry, forbidden thoughts, washing, hoarding).ResultsIt was possible to include a total of 15 original papers in the assessment. The “forbidden thoughts” factor, which also includes compulsion to control, is associated mainly with activations in brain structures of the cognitive control system, i.e. the basal ganglia and parts of the anterior cingulate cortex (ACC). Therefore, the neural representation pattern of “forbidden thoughts” differs clearly from that of “washing”, in which cerebral regions of emotional control seem to be particularly involved, i.e. the orbito-frontal cortex (OFC), ACC, the amygdala and insula. On the other hand, the “hoarding and collecting” dimension is primarily associated with brain areas involved in decision-making, i.e. the ventro-medial OFC, the dorsal ACC and the dorso-lateral prefrontal cortex (DLPC).DiscussionThe results confirm the hypothesis that all dimensions of OCD are based on different neuronal networks, which underlines the neurobiological heterogeneity of the clinical picture of OCD, thus pointing the way for future research strategies.

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A-90 Personality Tests in Neuropsychological Assessment: Determining the Presence of Psychotic and Obsessive Compulsive Disorders in 3 Individuals with Autism Spectrum Disorder

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acab062.108 ◽

2021 ◽

Vol 36 (6) ◽

pp. 1137-1137

Author(s):

Kathleen Torsney

Keyword(s):

Autism Spectrum Disorder ◽

Psychiatric Disorders ◽

Case Studies ◽

Correct Diagnosis ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Future Research ◽

Obsessive Compulsive ◽

Personality Tests ◽

Compulsive Disorder

Abstract Objective The assessment of personality and psychopathology in an individual who has symptoms of autism spectrum disorder (ASD) can be a challenging task due to the overlap of characteristic behaviors associated with ASD and markers of psychopathology. Through the examination of key factors in 3 case studies of neuropsychological assessments, this poster outlines steps to facilitate the correct diagnosis of psychiatric disorders in persons with autism spectrum disorder. Method This poster explores 3 case studies in which an individual exhibited signs of a psychiatric disorder as well as ASD. The author describes how the personality tests such as the MMPI-2 and MMPI-RF were administered and interpreted and how case history and test taking behavior affected the understanding of the results. Results The poster highlights critical factors in differentiating psychiatric disorders and symptoms that are part of the ASD. For example, in all 3 case studies, the individuals had significant difficulty with the computerized version of the test and needed to take it with paper and pencil. The author also outlines examples where the symptoms are manifestations of the ASD, such as perseveration and rigid thinking and when they are attributable to an obsessive–compulsive disorder. Further, the author differentiates signs of psychosis in a person with ASD from the typical tangential and circumstantial speech associated with ASD. Conclusion The author offers suggestions for administering personality tests to persons with ASD, for interpreting the results of the tests, and for conducting future research to facilitate the differentiation between symptoms consistent with ASD and with psychopathology.

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Functional MRI in Psychiatric Disorders

Functional MRI ◽

10.1093/med/9780190297763.003.0006 ◽

2018 ◽

pp. 91-118

Author(s):

Jie Lisa Ji ◽

Alan Anticevic

Keyword(s):

Magnetic Resonance Imaging ◽

Bipolar Disorder ◽

Psychiatric Disorders ◽

Large Scale ◽

Neural Substrates ◽

Behavioral Symptoms ◽

Neural Systems ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Psychiatric Conditions

sSince its introduction to clinical research, functional magnetic resonance imaging (fMRI) has had a pivotal role in understanding the systems-level neural substrates of psychiatric disorders. fMRI is a powerful tool for the field of psychiatry because it is well suited to studying large-scale neural systems and distributed neuropathology, which are thought to underlie many of the behavioral symptoms in psychiatric conditions. This chapter highlights key fMRI findings in four major types of psychiatric disorders: schizophrenia, mood disorders (including major depressive disorder and bipolar disorder), obsessive-compulsive disorder, and posttraumatic stress disorder.

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Familial coaggregation of major psychiatric disorders among first-degree relatives of patients with obsessive-compulsive disorder: a nationwide study

Psychological Medicine ◽

10.1017/s0033291719003696 ◽

2020 ◽

pp. 1-8

Author(s):

Mao-Hsuan Huang ◽

Chih-Ming Cheng ◽

Shih-Jen Tsai ◽

Ya-Mei Bai ◽

Cheng-Ta Li ◽

...

Keyword(s):

Bipolar Disorder ◽

Psychiatric Disorders ◽

Obsessive Compulsive Disorder ◽

Autism Spectrum ◽

Research Database ◽

Dependent Manner ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

First Degree Relatives ◽

Dose Dependent

Abstract Background Whether the first-degree relatives (FDRs) of patients with obsessive-compulsive disorder (OCD) have an increased risk of the major psychiatric disorders, namely schizophrenia, bipolar disorder, OCD, major depressive disorder (MDD), autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD), remains unclear. Methods Using the Taiwan National Health Insurance Research Database with the whole population sample size (n = 23 258 175), 89 500 FDRs, including parents, offspring, siblings, and twins, of patients with OCD were identified in our study. The relative risks (RRs) of major psychiatric disorders were assessed among FDRs of patients with OCD. Results FDRs of patients with OCD had higher RRs of major psychiatric disorders, namely OCD (RR 8.11, 95% confidence interval (CI) 7.68–8.57), bipolar disorder (RR 2.85, 95% CI 2.68–3.04), MDD (RR 2.67, 95% CI 2.58–2.76), ASD (RR 2.38, 95% CI 2.10–2.71), ADHD (RR 2.19, 95% CI 2.07–2.32), and schizophrenia (RR 1.97, 95% CI 1.86–2.09), compared with the total population. Different familial kinships of FDRs, such as parents, offspring, siblings, and twins consistently had increased risks for these disorders. In addition, a dose-dependent relationship was found between the numbers of OCD probands and the risk of each major psychiatric disorder. Conclusions The FDRs, including parents, offspring, siblings, and twins, of patients with OCD have a higher risk of OCD, schizophrenia, bipolar disorder, MDD, ADHD, and ASD. The familial co-aggregation of OCD with OCD and other major psychiatric disorders was existent in a dose-dependent manner. Given the increased risks of psychiatric disorders, medical practitioners should closely monitor the mental health of the FDRs of patients with OCD.

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

General Psychiatry ◽

10.1136/gpsych-2018-100007 ◽

2018 ◽

Vol 31 (3) ◽

pp. e100007 ◽

Cited By ~ 2

Author(s):

Andrea Amerio ◽

Anna Odone

Keyword(s):

Bipolar Disorder ◽

Obsessive Compulsive Disorder ◽

Standard Treatment ◽

Future Research ◽

Drug Discontinuation ◽

Obsessive Compulsive ◽

Obsessive Compulsive Symptoms ◽

Therapeutic Implications ◽

Compulsive Disorder ◽

Remarkable Improvement

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.

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The Orbitofrontal Cortex

10.1093/oso/9780198845997.001.0001 ◽

2019 ◽

Cited By ~ 12

Author(s):

Edmund T. Rolls

Keyword(s):

Bipolar Disorder ◽

Human Brain ◽

Obsessive Compulsive Disorder ◽

Orbitofrontal Cortex ◽

Multidisciplinary Approach ◽

Animal Behaviour ◽

Obsessive Compulsive ◽

Undergraduate Level ◽

Compulsive Disorder

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.

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Additive and Alternative Approaches to Treating Obsessive Compulsive Disorder

10.1093/oxfordhb/9780195376210.013.0086 ◽

2012 ◽

Author(s):

Jordana Muroff ◽

Abigail Ross ◽

Joseph Rothfarb

Keyword(s):

Obsessive Compulsive Disorder ◽

Behavioral Therapy ◽

Alternative Methods ◽

Herbal Remedies ◽

Future Research ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Specific Alternative ◽

Alternative Approaches ◽

Complementary And Alternative

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.

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Likely Exacerbation of Psychological Disorders from Covid-19 Response

Journal of Primary Care & Community Health ◽

10.1177/21501327211016739 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110167

Author(s):

Tara Rava Zolnikov ◽

Tanya Clark ◽

Tessa Zolnikov

Keyword(s):

Psychological Disorders ◽

Emotional Reactions ◽

Post Traumatic Stress ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Current State ◽

The Face ◽

Adults And Children ◽

Post Traumatic ◽

Anxiety Depression

Anxiety and fear felt by people around the world regarding the coronavirus pandemic is real and can be overwhelming, resulting in strong emotional reactions in adults and children. With depressive and anxiety disorders already highly prevalent in the general population (300 million worldwide), depression and/or anxiety specifically because of the pandemic response is likely. Moreover, the current state of panic in the face of uncertainty is apt to produce significant amounts of stress. While this situation has the potential to cause psychological disorders in previously unaffected populations, perhaps more impactful is the exacerbation of symptoms of many existing disorders including anxiety, depression, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD) and hoarding disorder.

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

Acta Neuropsychiatrica ◽

10.1111/j.1601-5215.2010.00457.x ◽

2010 ◽

Vol 22 (2) ◽

pp. 81-86 ◽

Cited By ~ 10

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.

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