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J Affect Disord. 2015 Nov 1;186:99-109. doi: 10.1016/j.jad.2015.06.005. Epub 2015 Jul 26.

The prevalence and predictors of comorbid bipolar disorder and obsessive-compulsive disorder: A systematic review and meta-analysis.

Author information

1
Department of Neuroscience, Section of Psychiatry, University of Parma, Parma, Italy; Mood Disorders Program, Tufts Medical Center, Boston, MA, USA. Electronic address: andrea.amerio@studenti.unipr.it.
2
School of Health and Social Care, University of Greenwich, London, UK. Electronic address: brendon.stubbs@kcl.ac.uk.
3
School of Medicine-Public Health Unit, University of Parma, Parma, Italy; Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA. Electronic address: anna.odone@mail.harvard.edu.
4
Department of Mental Health, Local Health Service, Parma, Italy. Electronic address: mtonna@ausl.pr.it.
5
Department of Neuroscience, Section of Psychiatry, University of Parma, Parma, Italy; Department of Mental Health, Local Health Service, Parma, Italy. Electronic address: carlo.marchesi@unipr.it.
6
Mood Disorders Program, Tufts Medical Center, Boston, MA, USA; Tufts University Medical School, Department of Psychiatry and Pharmacology, Boston, MA, USA. Electronic address: nghaemi@tuftsmedicalcenter.org.

Abstract

BACKGROUND:

Although some authors have recently investigated the co-occurrence of anxiety and bipolar disorders, the topic remains insufficiently studied. Defining the prevalence and predictors of BD-OCD comorbidity has important nosological, clinical and therapeutic implications.

METHODS:

A systematic review and meta-analysis was conducted on the prevalence and predictors of comorbid BD-OCD. Relevant papers published through March 30th, 2015 were identified searching the electronic databases MEDLINE, Embase, PsycINFO and the Cochrane Library.

RESULTS:

46 articles met inclusion criteria. The pooled prevalence of OCD in BD was 17.0% (95% CI 12.7-22.4%), which was comparable to the results reported by the pooled prevalence of BD in OCD (18.35%, 95% CI 13.2-24.8%). With regard to OCD-BD predictors, a higher mean age predicted a lower prevalence of OCD in BD patients. Sub group meta-analyses reported higher OCD prevalence rates in BD children and adolescents (24.2%, compared to 13.5% in adults), in BD-I patients (24.6%, compared to 13.6% in mixed BD patients), and among population-based studies (22.2%, compared to 13.2% in hospital-based studies).

LIMITATIONS:

Most studies use retrospective assessment scales with low sensitivity in discriminating true ego-dystonic obsessions from depressive ruminations that may bias results towards an overestimation of obsessive symptom prevalence.

CONCLUSIONS:

This first systematic review and meta-analysis of the prevalence and predictors of comorbid BD-OCD confirms that BD-OCD comorbidity is a common condition in psychiatry with children and adolescents and BD-I patients as the most affected subgroups.

KEYWORDS:

Bipolar disorder; Obsessiveā€“compulsive disorder; predictors; prevalence

PMID:
26233320
DOI:
10.1016/j.jad.2015.06.005
[Indexed for MEDLINE]

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