Clinical management of comorbid bipolar disorder and obsessive-compulsive disorder: A case series.: BD-OCD comorbidity: A case series.

Clinical management of comorbid bipolar disorder and obsessive-compulsive disorder: A case series.

BD-OCD comorbidity: A case series.

Authors

  • Andrea Amerio Inpatient Mental Health Service, SS. Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
  • Matteo Tonna Department of Medicine and Surgery, Unit of Neuroscience, University of Parma, Parma, Italy
  • Anna Odone School of Medicine, Vita-Salute San Raffaele University, Milan, Italy

Keywords:

bipolar, obsessive-compulsive, comorbidity, treatment

Abstract

Background:Apparent comorbidity between bipolar disorder (BD) and obsessive-compulsive disorder (OCD) is a common condition in psychiatry and it has important nosological and therapeutic implications. Although antidepressantsare the first line treatment for OCD, they can induce mood instability in BD. An optimal treatment approach remains to be defined.

Methods:Longitudinal clinical observation of three severe OCD patients who developed a manic episode during treatment with different classes of antidepressants.

Results: In our cases, three features support the hypothesis of an underlying bipolarity unmasked by the antidepressant used to treat OCD: positive family history for affective disorders, manic switch induced by antidepressantand improvement of affective and obsessive-compulsivesymptoms with mood stabilizers and atypical antipsychotics.

Conclusions:Osler’s view that medicine should be treatment of diseases, not of symptoms, is consistent with the approach of mood stabilization as a first objective in BD-OCD patients, as opposed to immediate treatment with antidepressants. Only persistent OCD patients should be prescribed antidepressants in as low a dose as feasible.

Author Biography

Andrea Amerio, Inpatient Mental Health Service, SS. Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy

Department of Neuroscience, Section of Psychiatry, University of Parma, Parma, Italy

Resident in Psychiatry

PhD Candidate in Medical Sciences

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Published

15-11-2018

Issue

Section

CASE REPORTS

How to Cite

1.
Clinical management of comorbid bipolar disorder and obsessive-compulsive disorder: A case series.: BD-OCD comorbidity: A case series. Acta Biomed [Internet]. 2018 Nov. 15 [cited 2024 Jun. 17];89(4):581-4. Available from: https://mattioli1885journals.com/index.php/actabiomedica/article/view/7621

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