Bipolar disorder (BD) is a common mental disorder, with approximately 2.4% lifetime prevalence in the general population. In addition, the co‐occurrence of other psychiatric disorders with BD is very high, with as many as 65% to 95% meeting the diagnostic criteria for comorbid conditions(1). Of these, about 25% are comorbid with obsessive‐compulsive disorder (OCD), and 10.6% with gambling disorder (GD) (2). Moreover, BD patients with OCD are more likely to be comorbid with impulse‐control disorder, including GD, than those without OCD. Comorbid OCD in BD is associated with younger age of onset, greater risk of suicide, rapid cycling (3) or more progressively depressive episodes, more severe impairment in social function, and poorer response to treatment, including pharmacologic (hypo) manic switch, lower lithium responsiveness, and exacerbation of OCD symptoms by neuroleptic agents. Therefore, if BD with comorbid OCD further co‐occurs with GD, it inevitably adds to the complexity and difficulty in treating BD. Previous systematic reviews show that treatment of BD and comorbid OCD or GD remains a challenge, since few evidence‐based treatment options are available. Recently, risperidone, quetiapine, olanzapine, and aripiprazole have been reported to be effective in the treatment of BD with OCD as an add‐on therapy (4), suggesting atypical antipsychotics might play a role in the treatment of BD with comorbid OCD.

中文翻译：

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齐帕西酮用于治疗躁郁症，强迫症和赌博症。

躁郁症（BD）是一种常见的精神障碍，在一般人群中，一生的患病率约为2.4％。此外，其他精神疾病与BD的并发率很高，多达65％至95％符合合并症的诊断标准（1）。其中，约有25％与强迫症（OCD）合并，而10.6％与赌博性疾病（GD）合并（2）。此外，患有OCD的BD患者比没有OCD的患者更容易合并包括GD在内的冲动控制障碍。BD的强迫症OCD与发病年龄年轻，自杀风险更高，快速骑自行车（3）或更严重的抑郁发作，社会功能严重受损以及对治疗的反应较差有关，包括药理学（低血压）躁狂切换，锂反应性 和抗精神病药会加剧强迫症症状。因此，如果合并有OCD的BD与GD并发，则不可避免地增加了治疗BD的复杂性和难度。以往的系统评价表明，由于几乎没有循证医学的治疗选择，因此对BD和合并症的OCD或GD的治疗仍然是一个挑战。最近，据报道，利培酮，喹硫平，奥氮平和阿立哌唑作为OCD的附加疗法可有效治疗BD（4），这表明非典型抗精神病药可能在合并OCD的BD治疗中发挥作用。因为很少有基于证据的治疗选择。最近，据报道，利培酮，喹硫平，奥氮平和阿立哌唑作为OCD的附加疗法可有效治疗BD（4），这表明非典型抗精神病药可能在合并OCD的BD治疗中发挥作用。因为很少有基于证据的治疗选择。最近，据报道，利培酮，喹硫平，奥氮平和阿立哌唑作为OCD的附加疗法可有效治疗BD（4），这表明非典型抗精神病药可能在合并OCD的BD治疗中发挥作用。