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Abstract：
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.
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.
摘要：
背景：双相情感障碍（BD）和强迫症（OCD）共病是精神病学中的一种新兴疾病，与相关的新闻学，临床,和治疗意义。
方法：我们更新了以前关于流行病学和标准诊断验证者的系统综述（包括现象学，病程,遗传,生物标记,和治疗反应）的BD-OCD。通过搜索电子数据库MEDLINE，确定了直到（包括）2023年10月15日发表的相关论文，Embase,心理信息,和Cochrane图书馆,根据PRISMA声明(PROSPERO注册号，CRD42021267685）。
结果：我们确定了38篇新文章，这增加了之前的64个，并将总数提高到102个。BD的终生合并症患病率为0.26％至27.8％，OCD的终生合并症患病率为0.3％至53.3％。这两种疾病的发作似乎经常重叠，尽管原发性疾病的出现可能会影响预后。与单一诊断相比，BD-OCD表现出明显的OC症状模式，通常在偶发病程后，发生在高达75%的病例中(与3%)。值得注意的是,这些OC症状在抑郁发作时趋于恶化(78%),在躁狂或轻躁狂发作时趋于改善(64%).同样，与没有BD-OCD的患者相比，BD病程似乎是慢性的。此外,有BD-OCD合并症的个体比没有合并症的个体(平均4.1±2.7)经历更多的抑郁发作(平均8.9±4.2).
结论：我们发现抗抑郁药引起躁狂/轻躁狂发作的可能性更大（60％vs.4.1%)，和情绪稳定剂与抗精神病药的附加出现作为首选治疗。根据我们以前的工作，BD-OCD合并症包括比个体疾病具有更大的疾病学和临床复杂性的病症。
方法：我们更新了以前关于流行病学和标准诊断验证者的系统综述（包括现象学，病程,遗传,生物标记,和治疗反应）的BD-OCD。通过搜索电子数据库MEDLINE，确定了直到（包括）2023年10月15日发表的相关论文，Embase,心理信息,和Cochrane图书馆,根据PRISMA声明(PROSPERO注册号，CRD42021267685）。
结果：我们确定了38篇新文章，这增加了之前的64个，并将总数提高到102个。BD的终生合并症患病率为0.26％至27.8％，OCD的终生合并症患病率为0.3％至53.3％。这两种疾病的发作似乎经常重叠，尽管原发性疾病的出现可能会影响预后。与单一诊断相比，BD-OCD表现出明显的OC症状模式，通常在偶发病程后，发生在高达75%的病例中(与3%)。值得注意的是,这些OC症状在抑郁发作时趋于恶化(78%),在躁狂或轻躁狂发作时趋于改善(64%).同样，与没有BD-OCD的患者相比，BD病程似乎是慢性的。此外,有BD-OCD合并症的个体比没有合并症的个体(平均4.1±2.7)经历更多的抑郁发作(平均8.9±4.2).
结论：我们发现抗抑郁药引起躁狂/轻躁狂发作的可能性更大（60％vs.4.1%)，和情绪稳定剂与抗精神病药的附加出现作为首选治疗。根据我们以前的工作，BD-OCD合并症包括比个体疾病具有更大的疾病学和临床复杂性的病症。
