Résumé
Background: Bipolar disorder (BD) is commonly comorbid with other psychiatric conditions, such as obsessive-compulsive disorder (OCD). Despite increasing interest in this comorbidity, quantitative data on its clinical characteristics remain limited. This systematic review and meta-analysis aimed to evaluate the clinical impact of OCD comorbidity in BD by comparing individuals with BD and OCD (BD-OCD) to those with BD without OCD.Methods: We systematically searched PubMed/MEDLINE, Scopus, PsycINFO, and Web of Science databases from inception to April 15th, 2024. Random-effects meta-analyses were conducted to compare BD- OCD and BD without OCD groups across multiple clinical domains, including illness course, comorbidities, functioning, and suicidality.Results: From 11,959 initial records screened, 26 studies were included in the qualitative synthesis, with 22 eligible for meta-analysis. Individuals with BD-OCD showed higher odds of experiencing chronic mood episodes (OR=9.42; 95%CI=2.23, 39.9), rapid cycling (OR=1.92; 95%CI=1.04, 3.53), comorbid eating disorders (OR=3.37; 95%CI=1.99, 5.7), panic disorder (OR=3.3; 95%CI=2.11, 5.2), substance use disorders (OR=1.39; 95%CI=1.02, 1.89), and lifetime suicide attempts (OR=1.85; 95%CI=1.21, 2.84). Additionally, they presented earlier onset of BD (SMD=-0.27; 95%CI=-0.52, -0.01) and reduced functioning (SMD=-0.42; 95%CI= 0.59, -0.24). Most data were derived from adult populations, limiting the evidence available for children and adolescents.Conclusions: BD-OCD presents a more severe and complex clinical profile, requiring specialized assessment and integrated treatment approaches. Identifying these clinical features may support earlier recognition and inform more personalized interventions for this high-risk population.