Comorbidade entre transtorno bipolar e transtorno obsessivo-compulsivo: aspectos epidemiológicos, clínicos e terapêuticos.
DOI:
https://doi.org/10.25118/2763-9037.2022.v12.295Palavras-chave:
Transtorno Bipolar, Transtorno Obsessivo-Compulsivo, ComorbidadeResumo
Introdução: O transtorno bipolar (TB) e o transtorno obsessivo-compulsivo (TOC) são altamente comórbidos. Esta comorbidade está associada a impacto clínico significativo. Este artigo revisa os dados disponíveis sobre aspectos epidemiológicos, características clínicas e opções de tratamento da comorbidade TB-TOC. Métodos: Foi realizada revisão bibliográfica não sistemática na base de dados PUBMED, no idioma inglês. As seguintes palavras-chave foram incluídas na busca: obsessive-compulsive disorder, bipolar disorder, comorbidity. Resultados: Entre as amostras de pacientes com TB, a prevalência de TOC comórbido foi estimada em cerca de 17%. Entre as amostras de pacientes com TOC, a prevalência de TB foi estimada em, aproximadamente, 18%. Os dados sobre a validade diagnóstica da comorbidade são limitados. Os pacientes com TB-TOC parecem apresentar curso episódico dos sintomas obsessivo-compulsivos (SOC) com maior frequência do que os pacientes com TOC sem TB. A comorbidade parece estar associada à maior número total de episódios depressivos e à ocorrência mais frequente de comportamentos suicidas. Conteúdos obsessivos de simetria, agressão, religiosidade e acumulação parecem ser mais frequentes em pacientes com TB-TOC. O uso de estabilizadores do humor é a principal estratégia de tratamento. Conclusão: A prevalência da comorbidade parece ser relevante. O TB-TOC pode estar associado à caracteristicas clínicas particulares. Os dados sobre a validade diagnóstica da comorbidade são inconclusivos. A estabilização do humor é o primeiro objetivo no manejo clínico.
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