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Obsessive–compulsive disorder comorbid with schizophrenia and bipolar disorder

Obsessive Compulsive Disorder (OCD) and Obsessive Compulsive Symptoms (OCS) are known to be highly comorbid with bipolar disorder and schizophrenia. Comorbid OCD/OCS influences the course of schizophrenia and bipolar disorder. There is also some evidence to suggest that a diagnosis of OCD may be ass...

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Autores principales: Sharma, Lavanya P., Reddy, Y. C. Janardhan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6343407/
https://www.ncbi.nlm.nih.gov/pubmed/30745688
http://dx.doi.org/10.4103/psychiatry.IndianJPsychiatry_527_18
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author Sharma, Lavanya P.
Reddy, Y. C. Janardhan
author_facet Sharma, Lavanya P.
Reddy, Y. C. Janardhan
author_sort Sharma, Lavanya P.
collection PubMed
description Obsessive Compulsive Disorder (OCD) and Obsessive Compulsive Symptoms (OCS) are known to be highly comorbid with bipolar disorder and schizophrenia. Comorbid OCD/OCS influences the course of schizophrenia and bipolar disorder. There is also some evidence to suggest that a diagnosis of OCD may be associated with elevated risk for later development of psychosis and bipolar disorder. Comorbid OCD/OCS is associated with a greater severity of schizophrenia phenotype and poorer prognosis. In addition, certain atypical antipsychotics, clozapine in particular are known to induce or worsen OCS in schizophrenia. OCD when comorbid with bipolar disorder mostly runs an episodic course with worsening and improvement of OCD/OCS in depressive and in manic/hypomanic phases respectively. There is limited systematic data on the treatment of OCD in schizophrenia and bipolar disorder. When OCD presents in the context of schizophrenia, management may include treatment with atypical antipsychotics with limited serotonergic properties, changing the antipsychotic, reduction in the dose of the antipsychotic, addition of cognitive-behavior therapy (CBT), or a specific serotonin reuptake inhibitor (SSRI). When OCD is comorbid with bipolar disorder, mood stabilization is the priority. CBT may be preferred over SSRIs to treat OCD/OCS that persist in between the mood episodes because SSRIs may induce a switch or worsen the course of bipolar disorder. SSRIs when indicated have to be used judiciously under the cover of adequate mood stabilization.
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spelling pubmed-63434072019-02-11 Obsessive–compulsive disorder comorbid with schizophrenia and bipolar disorder Sharma, Lavanya P. Reddy, Y. C. Janardhan Indian J Psychiatry Review Article Obsessive Compulsive Disorder (OCD) and Obsessive Compulsive Symptoms (OCS) are known to be highly comorbid with bipolar disorder and schizophrenia. Comorbid OCD/OCS influences the course of schizophrenia and bipolar disorder. There is also some evidence to suggest that a diagnosis of OCD may be associated with elevated risk for later development of psychosis and bipolar disorder. Comorbid OCD/OCS is associated with a greater severity of schizophrenia phenotype and poorer prognosis. In addition, certain atypical antipsychotics, clozapine in particular are known to induce or worsen OCS in schizophrenia. OCD when comorbid with bipolar disorder mostly runs an episodic course with worsening and improvement of OCD/OCS in depressive and in manic/hypomanic phases respectively. There is limited systematic data on the treatment of OCD in schizophrenia and bipolar disorder. When OCD presents in the context of schizophrenia, management may include treatment with atypical antipsychotics with limited serotonergic properties, changing the antipsychotic, reduction in the dose of the antipsychotic, addition of cognitive-behavior therapy (CBT), or a specific serotonin reuptake inhibitor (SSRI). When OCD is comorbid with bipolar disorder, mood stabilization is the priority. CBT may be preferred over SSRIs to treat OCD/OCS that persist in between the mood episodes because SSRIs may induce a switch or worsen the course of bipolar disorder. SSRIs when indicated have to be used judiciously under the cover of adequate mood stabilization. Medknow Publications & Media Pvt Ltd 2019-01 /pmc/articles/PMC6343407/ /pubmed/30745688 http://dx.doi.org/10.4103/psychiatry.IndianJPsychiatry_527_18 Text en Copyright: © 2019 Indian Journal of Psychiatry http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Review Article
Sharma, Lavanya P.
Reddy, Y. C. Janardhan
Obsessive–compulsive disorder comorbid with schizophrenia and bipolar disorder
title Obsessive–compulsive disorder comorbid with schizophrenia and bipolar disorder
title_full Obsessive–compulsive disorder comorbid with schizophrenia and bipolar disorder
title_fullStr Obsessive–compulsive disorder comorbid with schizophrenia and bipolar disorder
title_full_unstemmed Obsessive–compulsive disorder comorbid with schizophrenia and bipolar disorder
title_short Obsessive–compulsive disorder comorbid with schizophrenia and bipolar disorder
title_sort obsessive–compulsive disorder comorbid with schizophrenia and bipolar disorder
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6343407/
https://www.ncbi.nlm.nih.gov/pubmed/30745688
http://dx.doi.org/10.4103/psychiatry.IndianJPsychiatry_527_18
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