Navigating the intersection of ultradian rapid cycling bipolar disorder and OCD: A detailed case analysis


Research Team for Mental Health, University Psychiatric Service IBN Nafis Hospital, Mohammed VI University Hospital, Marrakech. Morocco.
Case Study
World Journal of Advanced Research and Reviews, 2024, 22(03), 1026–1031
Article DOI: 10.30574/wjarr.2024.22.3.1582


Publication history: 
Received on 12 April 2024 revised on 20 May 2024; accepted on 22 May 2024
This article presents a detailed case analysis of a 33-year-old woman diagnosed with ultradian rapid cycling bipolar disorder (RCBD) and obsessive-compulsive disorder (OCD). Bipolar disorder, a chronic psychiatric condition characterized by alternating mood episodes, includes a subtype known as rapid cycling, marked by at least four affective episodes within a year. Ultradian cycling, a more severe form, involves mood oscillations occurring more than once every 24 hours. The subject of this study, Nadia, exhibited extreme mood swings within 24 to 48 hours, along with severe OCD symptoms, complicating her treatment. Her case highlights the challenges of managing RCBD, particularly in the presence of comorbid OCD, and underscores the need for a comprehensive treatment approach combining pharmacological and psychotherapeutic strategies. Despite resistance to several medications, Nadia responded favorably to a regimen including sodium valproate, lamotrigine, and amisulpride, alongside cognitive-behavioral therapy (CBT). This case underscores the importance of personalized treatment plans and vigilant therapeutic approaches in managing complex cases of RCBD with OCD comorbidity. The findings contribute valuable insights into the interplay between bipolar disorder and OCD, emphasizing the necessity for integrated treatment modalities.
Rapid cycling bipolar disorder (RCBD); Ultradian cycling; Mood stabilizers; Lithium resistance; Depressive episode; Manic episode; OCD symptoms; Comorbidity; Suicide risk; Cognitive-behavioral therapy (CBT); Pharmacological interventions; Treatment resistance
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