Bipolar disorder and obsessive compulsive disorder comorbidity: Three case reports

Abstract

Comorbidity in bipolar disorder has been described as the co-occurrence of nonaffective DSM-III-R Axis I disorders or serious medical illnesses in bipolar patients. Almost all axis I and/or axis II disorders may co-occur with bipolar disorder. The most common ones are substance use disorders, panic disorder, obsessive compulsive disorder, and borderline personality disorder. Few studies estimated the prevalence of obsessive compulsive disorder (OCD) comorbidity with bipolar disorder (BD). Some case reports and treatment trials suggested that OCD might be seen comorbidly in patients with BD. Here we have reported three female cases of BD, who have had accompaniying OCD and discussed reciprocal interactions of the symptoms, illness courses, and treatments of both conditions.

Keywords

• bipolar disorder, obsessive-compulsive disorder, comorbidity, depression, mania

İki uçlu bozukluk ve obsesif kompulsif bozukluk ekhastalığı: Üç olgu sunumu

Öz

İki uçlu bozukluk (İUB) ekhastalığı, hastalarda mizaç bozuklukları dışındaki DSM-III-R eksen I hastalıkları ya da ciddi tıbbi hastalıkların birlikteliği olarak tarif edilmiştir. Birçok eksen I ve/veya eksen II hastalıkları İUB ile birlikte olabilir. Madde kullanımına bağlı bozukluklar, panik bozukluk, obsesif kompulsif bozukluk (OKB) ve borderline kişilik bozukluğu en sık rastlanan bozukluklardır. İUB’de OKB yaygınlığının saptanmasına dair az sayıda çalışma vardır. İlk olgu sunumları ve tedavi çalışmaları OKB ve İUB’nin ekhastalık olabileceğini düşündürmektedir. Biz burada OKB’nin eşlik ettiği üç kadın İUB hastanın belirtileri, hastalık seyirleri ve tedavilerinin karşılıklı etkileşimlerini tartışacağız.

Anahtar Kelimeler

• iki uçlu bozukluk, obsesif kompulsif bozukluk, ekhastalık, depresyon, mani

References

1. Perugi G, Akiskal HS, Pfanner C, Presta S, Gemignani A. The clinical impact of bipolar and unipolar affective comorbidity on obsessive compulsive disorder. J Affect Disord. 1997;46:15-23.
2. Hantouche EG, Kochman F, Demonfaucon C, Barrot I, Millet B, Lancrenon S. Bipolar obsessive-compulsive disorder: confirmation of results of the “ABC-OCD” survey in 2 populations of patient members versus non-members of an association. Encephale. 2002; 28:21-28.
3. Kalra H, Tandon R, Saluja B, Mohan I. Obsessive compulsive disorder:comorbidity in manic phase of bipolar disorder. Indiana J Psychiatry. 2002;44:377-9.
4. Gordon A, Rasmussen SA. Mood related obsessive compulsive symptoms in a patient with bipolar affective disorder. J Clin Psychiatry. 1988;49:27-8.
5. Krüger S, Cooke RG, Hasey GM, Jorna T, Persad E. Comorbidity of obsessive compulsive disorder in bipolar disorder. J Affect Disord. 1995;34:117-20.
6. Chen YW, Dilsaver SC. Comorbidity for obsessive-compulsive disorder in bipolar and unipolar disorders. Psychiatry Res. 1995;59:57-64.
7. Frederick M J. Risperidone in the treatment of affective illness and obsessive-compulsive disorder. J Clin Psychiatry. 1995;56:423-9.
8. Lakshmi N, Yatham, Stanley P, Kutcher, Vivek Kusumakar. Bipolar Disorder: A clinician’s guide to treatment management. Bipolar disorder and comorbid axis I disorders: diagnosis and management. Zarate CA, Tohen MF (Eds), New York, 2002, 115-39. Otto MW, Smits JAJ, Reese HE. Combined psychotherapy and pharmacotherapy for mood and anxiety disorders in adults: review and analysis. Focus. 2006;4:204-14.

9. Freeman MP, Freeman SA, McELroy SL. The comorbidity of bipolar and anxiety disorders: prevalence, psychobiology, and treatment issues. J Affect Disord. 2002;68:1-23.
10. Perugi G, Toni C, Frare F, Travierso MC, Hantouche E, Akiskal HS. Obsessive-compulsivebipolar comorbidity: a systematic exploration of clinical features and treatment outcome. J Clin Psychiatry. 2002;63:1129-34.
11. Kelsoe JR. Arguments for the genetic basis of the bipolar spectrum. J Affect Disord. 2003;73:183-97.
12. Akiskal HS. The temperamental foundations of affective disorders. Interpersonal origin and course of affective disorders. Mund C ve ark. (Ed), London, Gaskell, Royal College of Psychiatrists, 1996, 3Kesebir S, Vahip S, Akdeniz F, Yuncu Z. Bipolar bozuklukta mizaç ile klinik özelliklerin ilişkisi. Türk Psikiyatri Dergisi. 2005;16:1641
13. Zutshi A, Kamath P, Reddy YC. Bipolar and nonbipolar obsessivecompulsive disorder: a clinical exploration. Compr Psychiatry. 2007;48:245-51.
14. Magalhaes PV, Kapczinski NS, Kapczinski F. Correlates and impact of obsessive-compulsive comorbidity in bipolar disorder. Compr Psychiatry. 2010;51:353-6.
15. Maina G, Albert U, Pessina E, Bogetto F. Bipolar obsessivecompulsive disorder and personality disorders. Bipolar Disord. 2007;9:722-9.
16. Pashinian A, Faragian S, Levi A, Yeghiyan M, Gasparyan K,Weizman R. Obsessive compulsive disorder in bipolar disorder patients with first manic episode. J Affect Disord. 2006;94:151-6.
17. Koyuncu A, Tükel R, Ozyildirim I, Meteris H, Yazici O. Impact of obsessive-compulsive disorder comorbidity on the sociodemographic and clinical features of patients with bipolar disorder. Compr Psychiatry. 2010;51:293-7.
18. Presta S, Marazziti D, Dell Osso L, Pfanner C, Pfanner P. Obsessive-compulsive disorder in childhood and adolescence. Psychopathology. 2003;36:55-64.