Obsessive–Compulsive Disorder as an Epiphenomenon of Comorbid Bipolar Disorder? An Updated Systematic Review
Background: Bipolar disorder (BD) and obsessive–compulsive disorder (OCD) comorbidity is an emerging condition in psychiatry, with relevant nosological, clinical, and therapeutic implications. Methods: We updated our previous systematic review on epidemiology and standard diagnostic validators (incl...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
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MDPI AG
2024-02-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/13/5/1230 |
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| author | Renato de Filippis Andrea Aguglia Alessandra Costanza Beatrice Benatti Valeria Placenti Eleonora Vai Edoardo Bruno Domenico De Berardis Bernardo Dell’Osso Umberto Albert Pasquale De Fazio Mario Amore Gianluca Serafini Nassir S. Ghaemi Andrea Amerio |
| author_facet | Renato de Filippis Andrea Aguglia Alessandra Costanza Beatrice Benatti Valeria Placenti Eleonora Vai Edoardo Bruno Domenico De Berardis Bernardo Dell’Osso Umberto Albert Pasquale De Fazio Mario Amore Gianluca Serafini Nassir S. Ghaemi Andrea Amerio |
| author_sort | Renato de Filippis |
| collection | DOAJ |
| description | Background: Bipolar disorder (BD) and obsessive–compulsive disorder (OCD) comorbidity is an emerging condition in psychiatry, with relevant nosological, clinical, and therapeutic implications. Methods: We updated our previous systematic review on epidemiology and standard diagnostic validators (including phenomenology, course of illness, heredity, biological markers, and treatment response) of BD-OCD. Relevant papers published until (and including) 15 October 2023 were identified by searching the electronic databases MEDLINE, Embase, PsychINFO, and Cochrane Library, according to the PRISMA statement (PROSPERO registration number, CRD42021267685). Results: We identified 38 new articles, which added to the previous 64 and raised the total to 102. The lifetime comorbidity prevalence ranged from 0.26 to 27.8% for BD and from 0.3 to 53.3% for OCD. The onset of the two disorders appears to be often overlapping, although the appearance of the primary disorder may influence the outcome. Compared to a single diagnosis, BD-OCD exhibited a distinct pattern of OC symptoms typically following an episodic course, occurring in up to 75% of cases (vs. 3%). Notably, these OC symptoms tended to worsen during depressive episodes (78%) and improve during manic or hypomanic episodes (64%). Similarly, a BD course appears to be chronic in individuals with BD-OCD in comparison to patients without. Additionally, individuals with BD-OCD comorbidity experienced more depressive episodes (mean of 8.9 ± 4.2) compared to those without comorbidity (mean of 4.1 ± 2.7). Conclusions: We found a greater likelihood of antidepressant-induced manic/hypomanic episodes (60% vs. 4.1%), and mood stabilizers with antipsychotic add-ons emerging as a preferred treatment. In line with our previous work, BD-OCD comorbidity encompasses a condition of greater nosological and clinical complexity than individual disorders. |
| first_indexed | 2024-04-25T00:27:02Z |
| format | Article |
| id | doaj.art-c587679376054005a37d646415a2fa87 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-04-25T00:27:02Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-c587679376054005a37d646415a2fa872024-03-12T16:47:39ZengMDPI AGJournal of Clinical Medicine2077-03832024-02-01135123010.3390/jcm13051230Obsessive–Compulsive Disorder as an Epiphenomenon of Comorbid Bipolar Disorder? An Updated Systematic ReviewRenato de Filippis0Andrea Aguglia1Alessandra Costanza2Beatrice Benatti3Valeria Placenti4Eleonora Vai5Edoardo Bruno6Domenico De Berardis7Bernardo Dell’Osso8Umberto Albert9Pasquale De Fazio10Mario Amore11Gianluca Serafini12Nassir S. Ghaemi13Andrea Amerio14Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, ItalyDepartment of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16132 Genoa, ItalyDepartment of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), 1205 Geneva, SwitzerlandDepartment of Biomedical and Clinical Sciences Luigi Sacco, Luigi Sacco Hospital, University of Milan, 20157 Milan, ItalyDepartment of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16132 Genoa, ItalyDepartment of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16132 Genoa, ItalyDepartment of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16132 Genoa, ItalyNHS, Department of Mental Health, Psychiatric Service for Diagnosis and Treatment, Hospital “G. Mazzini”, 64100 Teramo, ItalyDepartment of Biomedical and Clinical Sciences Luigi Sacco, Luigi Sacco Hospital, University of Milan, 20157 Milan, ItalyDepartment of Medicine, Surgery and Health Sciences, University of Trieste and Department of Mental Health, Azienda Sanitaria Universitaria Giuliano Isontina—ASUGI, 34128 Trieste, ItalyPsychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, ItalyDepartment of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16132 Genoa, ItalyDepartment of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16132 Genoa, ItalyDepartment of Psychiatry, Tufts University School of Medicine, Boston, MA 02111, USADepartment of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16132 Genoa, ItalyBackground: Bipolar disorder (BD) and obsessive–compulsive disorder (OCD) comorbidity is an emerging condition in psychiatry, with relevant nosological, clinical, and therapeutic implications. Methods: We updated our previous systematic review on epidemiology and standard diagnostic validators (including phenomenology, course of illness, heredity, biological markers, and treatment response) of BD-OCD. Relevant papers published until (and including) 15 October 2023 were identified by searching the electronic databases MEDLINE, Embase, PsychINFO, and Cochrane Library, according to the PRISMA statement (PROSPERO registration number, CRD42021267685). Results: We identified 38 new articles, which added to the previous 64 and raised the total to 102. The lifetime comorbidity prevalence ranged from 0.26 to 27.8% for BD and from 0.3 to 53.3% for OCD. The onset of the two disorders appears to be often overlapping, although the appearance of the primary disorder may influence the outcome. Compared to a single diagnosis, BD-OCD exhibited a distinct pattern of OC symptoms typically following an episodic course, occurring in up to 75% of cases (vs. 3%). Notably, these OC symptoms tended to worsen during depressive episodes (78%) and improve during manic or hypomanic episodes (64%). Similarly, a BD course appears to be chronic in individuals with BD-OCD in comparison to patients without. Additionally, individuals with BD-OCD comorbidity experienced more depressive episodes (mean of 8.9 ± 4.2) compared to those without comorbidity (mean of 4.1 ± 2.7). Conclusions: We found a greater likelihood of antidepressant-induced manic/hypomanic episodes (60% vs. 4.1%), and mood stabilizers with antipsychotic add-ons emerging as a preferred treatment. In line with our previous work, BD-OCD comorbidity encompasses a condition of greater nosological and clinical complexity than individual disorders.https://www.mdpi.com/2077-0383/13/5/1230biological markersbipolar disordercomorbiditycourse of illnessepidemiologyheredity |
| spellingShingle | Renato de Filippis Andrea Aguglia Alessandra Costanza Beatrice Benatti Valeria Placenti Eleonora Vai Edoardo Bruno Domenico De Berardis Bernardo Dell’Osso Umberto Albert Pasquale De Fazio Mario Amore Gianluca Serafini Nassir S. Ghaemi Andrea Amerio Obsessive–Compulsive Disorder as an Epiphenomenon of Comorbid Bipolar Disorder? An Updated Systematic Review Journal of Clinical Medicine biological markers bipolar disorder comorbidity course of illness epidemiology heredity |
| title | Obsessive–Compulsive Disorder as an Epiphenomenon of Comorbid Bipolar Disorder? An Updated Systematic Review |
| title_full | Obsessive–Compulsive Disorder as an Epiphenomenon of Comorbid Bipolar Disorder? An Updated Systematic Review |
| title_fullStr | Obsessive–Compulsive Disorder as an Epiphenomenon of Comorbid Bipolar Disorder? An Updated Systematic Review |
| title_full_unstemmed | Obsessive–Compulsive Disorder as an Epiphenomenon of Comorbid Bipolar Disorder? An Updated Systematic Review |
| title_short | Obsessive–Compulsive Disorder as an Epiphenomenon of Comorbid Bipolar Disorder? An Updated Systematic Review |
| title_sort | obsessive compulsive disorder as an epiphenomenon of comorbid bipolar disorder an updated systematic review |
| topic | biological markers bipolar disorder comorbidity course of illness epidemiology heredity |
| url | https://www.mdpi.com/2077-0383/13/5/1230 |
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