Obsessive-compulsive disorder

What is obsessive-compulsive disorder in bipolar disorder?

Obsessive-compulsive disorder (OCD) involves persistent and intrusive thoughts (obsessions) and repetitive actions (compulsions). The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) defines obsessions as recurrent and persistent thoughts, urges, or impulses that are experienced as intrusive and unwanted, with associated anxiety or distress. The individual attempts to suppress these obsessions by performing a compulsion; repetitive behaviours (e.g., hand washing, ordering, checking) or thoughts (e.g., praying, counting, repeating words). The obsessions or compulsions are time-consuming and can cause significant impairment in social, occupational, or other areas of functioning.

Related disorders include hoarding disorder, excoriation disorder (skin-picking), body dysmorphic disorder (obsessive focus on a perceived flaw in appearance) and trichotillomania (hair-pulling).

What is the evidence for OCD in people with bipolar disorder?

Moderate quality evidence suggests the lifetime prevalence of obsessive-compulsive disorder in people with bipolar disorder is around 11% compared to 2.5% in the general population. This represents a large increased risk of obsessive-compulsive disorder in people with bipolar disorder.

The lifetime prevalence of obsessive-compulsive disorder in children and adolescents with bipolar disorder is around 17%, with adolescents showing higher rates of obsessive-compulsive disorder than children.

The current prevalence rate is also around 11% in people with bipolar disorder compared to 1.6% in the general population. The current prevalence rate during euthymia in people with bipolar disorder is around 7%.

The antipsychotic aripiprazole plus mood stabilisers may be effective therapy for obsessive-compulsive symptoms during manic episodes. The glutamate modulators topiramate or memantine plus mood-stabilisers may also relieve obsessive-compulsive symptoms during manic episodes.

October 2021

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Last updated at: 3:59 am, 20th October 2021
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Tags:  OCD

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