COMORBIDITY BETWEEN BIPOLAR AFFECTIVE DISORDER AND OBSESSIVE COMPULSIVE DISORDER

Abstract

Bipolar affective disorder (BPD) is a chronic mood disorder which impair functionality of the patient severely. Itincludes mania, hypomania, anddepressionepisodes. Obsessive-compulsive disorder (OCD) is a disorder marked by obsessions and compulsions. Obsessions are repetitive and involuntary thoughts distressing the patient severely and compulsions are repetitive actions o rthoughts reducing the impact of the obsessions. Some researchers consider that similar pathogenesis cause both disorders. Although similar pathogenesis theory hasn’t been proven comorbidity between these disorders are common. BPD and OCD both impair the functionality significantly. Comorbidity between these disorders also impair functionality of the patient causin gprolonged duration of disease, affecting clinical course, and impairing treatment compliance of the patients. Relationship between thedisordes are complicated and detailed assesment should be made to decide on medical treatment. In this review it was aimed to highlight the comorbid disorders of BPD and OCD, to revise the effect of comorbidity between BPD and OCD on the clinical course.An other aim was to mention the treatment options in comorbid cases

Keywords

• Bipolar affective disorder, obsessive compulsive disorder, comorbidity

Bipolar duygudurum bozukluğu ve obsesif kompülsif bozukluk ilişkisi

Öz

Bipolar duygudurum bozukluğu (BDB) depresyon, hipomani ve mani dönemlerinin görüldüğü işlevselliği önemli derecede bozan, kronik seyirli bir duygudurum bozukluğudur. Obsesif kompülsif bozukluk (OKB) ise tekrarlayıcı ve istem dışı akla gelen, kişinin sıkıntı duymasına yol açan düşünceler olan obsesyonlar ile bu obsesyonların etkisini azaltmaya yarayan düşünceler ve davranışlar olan kompülsiyonlarla seyreden bir bozukluktur.Bu iki hastalık arasında etyolojik bir ilişki olabileceğini savunan araştırmacılar bulunmaktadır. Bu henüz geçerlilik kazanmış bir teori olmasa da iki hastalığın eş tanı sıklığı yüksektir. Hem BDB hem de OKB işlevselliği önemli düzeyde bozan hastalıklar olup; iki hastalığın eş tanısında klinik seyir değişmekte, hastalık süresi uzamakta ve hastaların tedaviye uyumu bozulmaktadır. İki hastalık arasındaki ilişki komplekstir ve eş tanı durumlarında medikal tedaviye karar verirken ayrıntılı değerlendirme yapılması gerekmektedir. Bu gözden geçirme çalışmasında BDB ve OKB’de sık görülen eş tanıları, her iki hastalığın eş tanı durumlarında klinik seyir değişikliklerini vurgulamak ve eş tanı durumlarında tedavi seçeneklerini belirtmek amaçlanmıştır.

Anahtar Kelimeler

• Bipolar bozukluk, obsesif kompülsif bozukluk, komorbidite

Kaynakça

1. Amerio A, Odone A, Marchesi C, Ghaemi SN (2014) Treatment of comorbid bipolar disorder and obsessive-compulsive disorder: a systematic review. J Affect Disord, 66:258-63.
2. Brady CF (2014)Obsessive-compulsive disorder and common comorbidities. J Clin Psychiatry, 75(1):e02.
3. Chen YW, Dilsaver SC (1995) Comorbidity for obsessive-compulsive disorder in bipolar and unipolar disorders. PsychiatryRes, 59(1-2):57-64.
4. Darby L, Agius M, Zaman R (2011)Co- morbidity of bipolar affective disorder and obsessive compulsive disorder in a Bedford community psychiatry team. Psychiatr Danub, 23 Supp l1: S130-3.
5. Dell'Osso B, Buoli M, Bortolussi S, Camuri G, Vecchi V, Altamura AC (2011)Patterns of Axis I comorbidity in relation to age in patients with Bipolar Disorder: a cross-sectional analysis. J AffectDisord, 130(1-2):318-22.
6. Dilsaver SC, Benazzi F, Akiskal KK, Akiskal HS (2008)Differential patterns of lifetime multiple anxiety disorder comorbidity between Latino adults with bipolar I and major depressive disorders Bull Menninger Clin, 72(2):130-48.
7. Jann MW (2014)Diagnosis and treatment of bipolar disorders in adults: a review of the evidence on pharmacologic treatments. Am Health Drug Benefits, 7(9):489-99.
8. Joshi G, Wozniak J, Petty C, Vivas F,Yorks D, Biederman J, Geller D (2010)Clinical characteristics of comorbid obsessive-compulsive disorder and bipolar disorder in children and adolescents. BipolarDisord, 12(2):185-95.

9. Kim S, Yu BH, Lee DS, Kim JH (2012)Ruminative response in clinica lpatients with major depressive disorder, bipolar disorder, and anxiety disorders. J Affect Disord, 136(1-2):e77-81.
10. Kim SW, Berk L, Kulkarni J, Dodd S, de Castella A, Fitzgerald PB, Amminger GP, Berk M (2014)Impact of comorbid anxiety disorders and obsessive-compulsive disorder on 24-month clinical outcomes of bipolar I disorder. J AffectDisord, 166:243-8.
11. Koyuncu A, Tükel R, Ozyildirim I, Meteris H, Yazici O (2010) Impact of obsessive-compulsive disorder comorbidity on the sociodemographic and clinical features of patients with bipolar disorder. ComprPsychiatry, 51(3):293-7.
12. Krishnan KR (2005) Psychiatric and medical comorbidities of bipolar disorder. Psychosom Med, 67(1):1-8.
13. Kruger S, CookeRG, Hasey GM, Jorna T, Persad E (1995) Comorbidity of obsessive compulsive disorder in bipolar disorder. J Affect Disord, 17(34):117-120.
14. Kruger S, Bräunig P, Cooke RG (2000) Comorbidity of obsessive-compulsive disorder in recovered in patients with bipolar disorder. BipolarDisord, 2(1):71-4.
15. MagalhãesPV, Kapczinski NS, Kapczinski F (2010) Correlates and impact of obsessive- compulsive comorbidity in bipolardisorder. ComprPsychiatry, 51(4):353-6.
16. Mahasuar R, Janardhan Reddy YC, Math SB (2011) Obsessive-compulsive disorder with and without bipolar disorder. Psychiatry Clin Neuro sci, 65(5):423-33.
17. Maher AR, Theodore G (2012) Summary of the comparative effectiveness review on off-label use of atypical antipsychotics. J Manag Care Pharm, 18(5SupplB):S1-20.
18. Masi G, Perugi G, Tony C, Millepiedi S, Mucci M, Bertini N (2004) Obsessive compulsive bipolar co-morbidity: Focus on children and adolescents. J Affect Disord, 78:175–83.
19. McElroy SL, Altshuler LL, Suppes T, Keck PE Jr, Frye MA (2001)Axis I psychiatric comorbidity and its relationship to historical illness variables in 288 patients with bipolar disorder. Am J Psychiatry, 158(3):420-6.
20. Pedro VSM, Kapczinski NS, Kapczinski F (2010)Correlates and impact of obsessive- compulsive comorbidity in bipolar disorder. Compr Psychiatry, 51:353-6.
21. Perugi G, Akiskal HS, Pfanner C, Presta S, Gemignani A, Milanfranchi A, Lensi P, Ravagli S, Cassano GB (1997)The clinical impact of bipolar and unipola raffective comorbidity on obsessive- compulsive disorder. J Affect Disord, 46(1):15-23.
22. Perugi G, Akiskal HS, Geminagi A, Pfanner C, Presta S, Milanfranchi A (1998) Episodic course in obsessive compulsive disorder. Eur Arch Psychiatry Clin Neurosci, 248:240–4.
23. Post RM, Ostacher MJ, Singh V (2014)Controversies in the psychopharmacology of bipolar disorder.J Clin Psychiatry, 75(11):30.
24. Provencher MD, Guimond AJ, Hawke LD (2012) Comorbidanxiety in bipolar spectrum disorders: a neglected research and treatment issue? J Affect Disord, 137(1-3):161-4.
25. Rakofsky JJ, Dunlop BW (2011) Treating nonspecific anxiety and anxiety disorders in patients with bipolar disorder: a review. J Clin Psychiatry, 72(1):81-90.
26. Sasson Y, ChopraM, Harrari E, Amitai K, Zohar J (2003) Bipolar comorbidity: from diagnostic dilemmas to therapeutic challenge. Int J Neuropsychopharmacol, Int J Neuropsychopharmacol, 6(2):139-44.
27. Shashidhara M, Sushma BR, Viswanath B, Math SB, JanardhanYC(2014)Comorbid obsessive compulsive disorder in patients with bipolar-I disorder. J Affect Disord, 174:367-371.
28. Simon NM, Otto MW, Wisniewski SR, Fossey M, Sagduyu K, Frank E, Sachs GS, Nierenberg AA, Thase ME, Pollack MH (2004) Anxiety disorder comorbidity in bipolar disorder patients: data from the first 500 participants in the Systematic Treatment Enhancement Program for Bipola rDisorder (STEP-BD). Am J Psychiatry, 161(12):2222-9.
29. Tamam L, Özpoyraz N (2002)Comorbidity of anxiety disorder among patients with bipolar I disorder in remission. Psychopathology, 35:203- 209.
30. Timpano KR, Rubenstein LM, Murphy DL (2012)Phenomenological features and clinical impact of affective disorders in OCD: a focus on the bipolar disorder and OCD connection. Depress Anxiety, 29(3):226-33.
31. Uguz F (2010) Successful treatment of comorbid obsessive-compulsive disorder with aripiprazole in three patients with bipolar disorder. Gen Hosp Psychiatry, 32(5):556-8.