Bipolar disorder and Obsessive compulsive disorder comorbidity: a case report

The frequent occurrence of anxiety disorders in bipolar patients is noteworthy in clinical and epidemiological studies. It was shown that, in bipolar disorder patients with comorbid anxiety disorder, therapeutic response was decreased and suicide risk was increased. Obsessive compulsive disorder is one of the most common comorbid anxiety disorders in bipolar patients and is reported to be present in 9-39% of the cases. Our case is a 39-year-old female patient, who is living apart from her husband and is a university graduate, who is actively working as a teacher. She was referred to our forensic outpatient clinic with a prediagnosis of kleptomania. In the psychiatric examination, the patient had good self-care and an age appropriate look. Her affect and mood were labile, cognitive functions were preserved and thought structure and content were normal. Upon analyzing past hospital records, we saw that she was hospitalized and followed up in the outpatient clinic with bipolar disorder and comorbid Obsessive compulsive disorder diagnosis. Clinical follow up revealed that she had manic episodes induced by OCD medications and she had some kleptomaniac behaviors continued during remission periods. Here we aimed to emphasize the difficulties in the pharmacological treatment of patients with comorbid bipolar disorder and Obsessive compulsive disorder.