Suicide risk in comorbid bipolar disorder and obsessive-compulsive disorder: A systematic review

• Main Author: Andrea Amerio
• Format: Article
• Language: English
• Published: SAGE Publishing 2019-01-01
• Series: Indian Journal of Psychological Medicine
• Subjects: Bipolar; comorbidity; obsessive-compulsive; suicide
• Online Access: http://www.ijpm.info/article.asp?issn=0253-7176;year=2019;volume=41;issue=2;spage=133;epage=137;aulast=Amerio

Introduction: The co-occurrence of bipolar disorder (BD) and obsessive-compulsive disorder (OCD) seemed to be a poor prognostic factor associated with greater disability, lower social and occupational functioning, poorer treatment response, and higher suicidal ideas and attempts compared to BD patients. Materials and Methods: A systematic review was conducted on the risk of suicide in BD-OCD patients compared to BD patients. Relevant papers published through August 2018 were identified searching the electronic databases MEDLINE, EMBASE, PsycINFO, and the Cochrane Library. Results: In all cases, diagnoses were according to the standard Diagnostic and Statistical Manual criteria and were established using validated assessment scales. More than 80% of the selected studies presented higher rates of history of suicide attempts and lifetime depressive episodes in BD-OCD patients compared to non-comorbid patients. Conclusions: Osler's view that medicine should be a treatment of diseases, not of symptoms, is consistent with the approach of mood stabilization as the first objective in apparent BD-OCD patients, as opposed to immediate treatment with antidepressants. In line with that, especially in comorbid patients, lithium may be preferred because of its proven anti-suicidal effect.