Lifetime Bipolar Disorder comorbidity and related clinical characteristics in patients with primary Obsessive Compulsive Disorder: a report from the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS)

IntroductionBipolar disorder (BD) and obsessive compulsive disorder (OCD) are prevalent, comorbid, and disabling conditions, often characterized by early onset and chronic course. When comorbid, OCD and BD can determine a more pernicious course of illness, posing therapeutic challenges for clinicians. Available reports on prevalence and clinical characteristics of comorbidity between BD and OCD showed mixed results, likely depending on the primary diagnosis of analyzed samples.MethodsWe assessed prevalence and clinical characteristics of BD comorbidity in a large international sample of patients with primary OCD (n = 401), through the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS) snapshot database, by comparing OCD subjects with vs without BD comorbidity.ResultsAmong primary OCD patients, 6.2% showed comorbidity with BD. OCD patients with vs without BD comorbidity more frequently had a previous hospitalization (p < 0.001) and current augmentation therapies (p < 0.001). They also showed greater severity of OCD (p < 0.001), as measured by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS).ConclusionThese findings from a large international sample indicate that approximately 1 out of 16 patients with primary OCD may additionally have BD comorbidity along with other specific clinical characteristics, including more frequent previous hospitalizations, more complex therapeutic regimens, and a greater severity of OCD. Prospective international studies are needed to confirm our findings.Peer reviewe

Learning to Deal with Problematic Usage of the Internet

An easily accessible guide for patients, caregivers, family members, and health care professionals presenting a state of the art overview of Problematic Use of the Internet. Ever since its development in the early 1990’s, the Internet has become highly pervasive across most of the civilised world. While the majority of Internet users take advantage of its many positive uses (including professional and recreational ones), some individuals can develop Problematic Use of the Internet (which we will refer to as PUI). This term encompasses a wide range of repetitive disabling behaviors characterized by compulsivity and addiction. These include, but are not limited to, Internet gaming, compulsive online sexual behaviors/ cyberpornography, Internet-related buying or shopping disorder, Internet-related gambling disorder, cyberbullying, cyberchondria, and social media/network forum use, among others. Although PUI affects a minority of individuals who routinely use the Internet, several reports have documented a series of unhealthy lifestyles and medical disturbances which are thought to represent the consequences of severe forms of PUI, especially when it comes to youth. People affected by PUI and their family members often do not know about the signs and symptoms of this condition. For example, they do not know how to recognize PUI, or whom to go to for help, and often they do not know whether this is a treatable condition and/or how to manage it. Because of this, National Health Authorities around the World are concerned about the health and societal costs that PUI may have. Some researchers are starting to consider particular forms of PUI as a serious and disabling form of behavioral addiction. We developed this companion book in an attempt to provide an easily accessible guide for the public, patients, caregivers, family members, and health care professionals presenting a state of the art overview of PUI. This initiative stems from the work of an international panel of experts participating in a 4-year COST Action project “European Network for Problematic Usage of the Internet” CA16207, funded by the Horizon 2020 Framework Programme of the European Union, which began in October 2017 and whose Principle Investigator, Prof. Naomi Fineberg, aimed to bring a multidisciplinary and geographically diverse group of experts and opinion leaders together under one European-led network to: advance the understanding of PUI from a bio-psycho-social perspective, to clarify brain-based causal mechanisms, and to develop effective interventions for the various forms of disorder