ABSTRACT
AIM: Bipolar disorder (BD) is often comorbid with obsessive-compulsive disorder (OCD). In this study, we compared clinical profile and course of subjects with a primary diagnosis of OCD with and without BD. METHODS: We compared 34 subjects with primary diagnosis of OCD with BD and 57 subjects with a diagnosis of OCD without BD. Structured interview schedules, clinical rating scales, and information from clinical charts were utilized to assess patients. RESULTS: OCD with BD was characterized by: (i) an episodic course; (ii) a higher number of depressive episodes, greater suicidality and a higher rate of hospitalization; (iii) fewer pathological doubts and more miscellaneous compulsions; and (iv) poorer insight into obsessive-compulsive symptoms. CONCLUSIONS: Episodic course appears to be typical of OCD with BD. Bipolarity has a pathoplastic effect on OCD and it is possible that some forms of OCD and BD are pathophysiologically related. Bipolar OCD is associated with a higher rate of depressive episodes, higher suicidality and more frequent hospitalizations, suggesting greater morbidity. Long-term prospective follow-up studies and studies addressing pathophysiology and genetic basis are needed to understand the complexity of such comorbidity.
Subject(s)
Bipolar Disorder/psychology , Obsessive-Compulsive Disorder/psychology , Adult , Bipolar Disorder/complications , Bipolar Disorder/diagnosis , Disease Progression , Female , Hospitalization/statistics & numerical data , Humans , Intuition , Male , Middle Aged , Obsessive-Compulsive Disorder/complications , Obsessive-Compulsive Disorder/diagnosis , Psychiatric Status Rating Scales/statistics & numerical data , Suicidal IdeationABSTRACT
INTRODUCTION: Palatal tremor, characterized by rhythmic contractions of the soft palate, can occur secondary to pathology in the dentato-rubro-olivary pathway, or in the absence of such structural lesions. Its pathogenesis is only partially understood. We describe a case of probable drug-induced palatal tremor. CASE PRESENTATION: A 27-year-old Indian man had taken carbamazepine and lithium for 7 years for the treatment of a manic episode. He presented with a one-year history of bilateral rhythmic oscillations of his soft palate and tremors of his tongue. There were no other abnormalities detected from his examination or after detailed investigation. CONCLUSION: Palatal tremors may result from medication used in the treatment of psychiatric disorders.
ABSTRACT
Hormonal side effects of antidepressants are infrequent, and galactorrhea is seldom mentioned among tricyclic antidepressant (TCA) and selective serotonin reuptake inhibitor (SSRI)-related side effects. Antidepressants can directly stimulate postsynaptic 5-HT receptors in the hypothalamus or indirectly inhibit the tuberoinfundibular dopaminergic neurons through 5-HT, which may increase prolactin levels and later cause galactorrhea. We describe a case of euprolactinemic galactorrhea in a postmenopausal woman, induced by imipramine and escitalopram. This report highlights the presence of unidentified novel mechanisms of antidepressant-induced galactorrhea and other possible contributors.
