Indian Journal of Psychological Medicine
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Year : 2019  |  Volume : 41  |  Issue : 2  |  Page : 133-137

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

Inpatient Mental Health Service, SS. Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy; Mood Disorders Program, Tufts Medical Center, Boston, MA, USA

Correspondence Address:
Dr. Andrea Amerio
Department of Mental Health, SS. Antonio e Biagio e Cesare Arrigo Hospital, Via Venezia 16, Alessandria (AL) - 15121

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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/IJPSYM.IJPSYM_367_18

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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.

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