Anxiety disorders comorbidity in bipolar I, bipolar II and unipolar major depression: results from a population-based study in Hungary

Rihmer, Zoltán; Szádóczky, Erika; Füredi, János; Kiss, Kitty; Papp, Zsuzsa

doi:10.1016/s0165-0327(01)00309-3

Cited by 92 publications

(69 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We found a higher but not significant proportion of comorbid anxiety disorders are associated with bipolar II and bipolar NOS disorders rather than bipolar I disorder, in accordance to previous studies [Cassano et al, 1999;Doughty et al, 2004;Pini et al, 1997;Perugi et al, 1999]. Specific types of comorbid anxiety disorders that had been demonstrated to be strongly associated with bipolar disorder include PD [Cassano et al, 1999;Chen and Dilsaver, 1995a;Doughty et al, 2004;Mantere et al, 2006;Rihmer et al, 2001], PTSD [Mantere et al, 2006;Otto et al, 2004], OCD [Angst, 1998;Chen and Dilsaver, 1995b;Perugi et al, 1997Perugi et al, , 1999, and simple phobia [Mantere et al, 2006;Rihmer et al, 2001]. However, it is noteworthy that the rates of anxiety disorder comorbidity differ in these studies.…”

Section: Discussionsupporting

confidence: 91%

The effect of anxiety disorder comorbidity on treatment resistant bipolar disorders

Lee

Dünner

2008

Depress. Anxiety

View full text Add to dashboard Cite

High rates of anxiety disorders have been reported in bipolar disorders. We undertook this study to determine the impact of anxiety disorders on bipolar disorders in our tertiary care referral center. We reviewed the literature on this topic and also reviewed records of 44 treatment resistant bipolar patients evaluated by DLD at the Center for Anxiety and Depression. Twenty-three patients had comorbid panic disorder, posttraumatic stress disorder, or obsessive-compulsive disorder. We compared bipolar patients with and without a history of comorbid anxiety disorders regarding several clinical factors, including mean age, percentage of women, mean age of onset, history of suicide attempts, history of rapid cycling, history of substance abuse, family history, and mean ratings for mood rating scales. Statistical differences were assessed by chi(2) and t-tests. On several measures, bipolar patients with comorbid anxiety disorders were more significantly ill than bipolar patients without comorbid anxiety disorders. For instance, patients with an anxiety disorder were more likely to have an earlier age of onset of illness, have higher (worse) ratings on the Hamilton Anxiety Rating Scale, 17-item Hamilton Depression Rating Scale, Montgomery and Asberg Depression Rating Scale, Beck Depression Inventory, and lower (more impaired) ratings on the Global Assessment of Functioning Scale. Comorbid anxiety disorders were also associated with a more frequent history of substance abuse and higher ratings for suicidal ideation. Anxiety disorders negatively impact the course of bipolar disorders. The high prevalence and risk rate of comorbid anxiety disorders in bipolar patients highlight the need for greater clinical attention to this population.

show abstract

Section: Discussionsupporting

confidence: 91%

The effect of anxiety disorder comorbidity on treatment resistant bipolar disorders

Lee

Dünner

2008

Depress. Anxiety

View full text Add to dashboard Cite

show abstract

“…Interestingly, bipolar II comorbidity did not decrease as a result of the duration change in the Kessler et al [2005a] study. This argument is consistent with a recent analysis of the comorbidity rates of bipolar disorders in the National Comorbidity Survey Replication, which demonstrated a strong relationship of both bipolar I (39%) and bipolar II (37%) disorders with GAD, and a study of comorbidity in a Hungarian epidemiological sample in which rates of comorbidity with GAD were higher in bipolar II disorder (21%) than MDD [14%; Rihmer et al, 2001]. These results suggest that classification of GAD and the mood disorders should reflect relationships with bipolar as well as unipolar mood disorders.…”

Section: Symptomatic Overlap Between Gad and Mood Disorderssupporting

confidence: 90%

Is generalized anxiety disorder an anxiety or mood disorder? Considering multiple factors as we ponder the fate of GAD

et al. 2008

View full text Add to dashboard Cite

Generalized anxiety disorder (GAD) and major depressive disorder (MDD) demonstrate a strong relationship to each other at both genotypic and phenotypic levels, and both demonstrate substantial loadings on a higher-order negative affectivity factor. On the basis of these findings, there have been a number of calls to reclassify GAD in the same category as MDD (the "distress disorders"). However, any consideration of the reclassification of GAD should also take into account a number of other factors not only related to GAD and MDD but also to the overlap of these disorders with other anxiety and mood disorders. First, GAD has established reliability and validity in its own right, and specific features (e.g., worry) may become obscured by attempts at reclassification. Second, examination of the nature of the overlap of GAD and MDD with each other and with other disorders suggests a more complex pattern of differences between these conditions than has been suggested (e.g., MDD has strong relationships with other anxiety disorders, and GAD may be more strongly related to fear than it may first appear). Third, although findings suggest that GAD and MDD may have overlapping heritable characteristics, other evidence suggests that the two disorders may be distinguished by both environmental factors and temporal presentations. Finally, although overlap between GAD and MDD is reflected in their relationships to negative affectivity, temporal relationships between these disorders may be demonstrated by functional changes in emotional responsivity.

show abstract

“…However, comparison of bipolar subtypes was not performed. Other studies have compared the rate differences of ADs or SUDs according to bipolar subtypes (Bauer et al, 2005;Boylan et al, 2004;Chengappa et al, 2000;Judd et al, 2003;Kolodziej et a., 2005;McElroy et al, 2001;Rihmer et al, 2001;Simon et al, 2004), but none assessed the interactions. Therefore, we proposed to analyze data from a cross-sectional dataset of a cohort of patients with rapid cycling bipolar I (RCBPDI) or II (RCBPDII) disorder to investigate the AD-SUD-bipolar subtype interactions.…”

Section: Introductionmentioning

confidence: 99%

Differential interactions between comorbid anxiety disorders and substance use disorder in rapid cycling bipolar I or II disorder

Gao

Tolliver

Kemp

et al. 2008

Journal of Affective Disorders

View full text Add to dashboard Cite

Objective-Anxiety disorders (AD) and substance use disorders (SUD) commonly co-occur with bipolar disorder. This study was undertaken to assess AD-SUD-bipolar subtype interactions.Methods-Extensive clinical interview and MINI were used to ascertain DSM-IV diagnoses of rapid cycling bipolar I (RCBPDI) or II (RCBPDII) disorder, SUDs, and ADs including generalized anxiety disorder (GAD), panic disorder (PD), and obsessive-compulsive disorder (OCD). Data at the initial assessment of four studies was used to compare the prevalence differences in ADs between RCBPDI and RCBPDII by using protocol-defined SUD categories, "Never," "Lifetime, but not recent," or "Recent."Results-Five-hundred sixty-six of 568 patients (RCBPDI n=320, RCBPDII n=246) were eligible for analyses. In the "Never" group (n=191), patients with RCBPDI and RCBPDII had similar risk for ADs. In the "Lifetime, but not recent" group (n=195), RCBPDI patients had significantly higher risks for GAD (OR=3.29), PD (OR=2.95), but not OCD, compared with their RCBPDII counterparts. Similarly, in the "Recent" group (n=180), RCBPDI patients also had significantly higher risks for GAD (OR=3.6), PD (OR=3.8), but not OCD, compared with their RCBPDII counterparts.Limitations-Data were cross-sectional and not all ADs were included.Conclusion-In this large cohort of patients with rapid cycling bipolar disorder, risk for having GAD, PD, but not OCD increased significantly in patients with bipolar I disorder compared to their bipolar II counterparts when a history of SUD was present. However, there were no significant differences in the risk for GAD, PD, or OCD between the subtypes among patients without a history of SUD.

show abstract

Anxiety disorders comorbidity in bipolar I, bipolar II and unipolar major depression: results from a population-based study in Hungary

Cited by 92 publications

References 24 publications

The effect of anxiety disorder comorbidity on treatment resistant bipolar disorders

The effect of anxiety disorder comorbidity on treatment resistant bipolar disorders

Is generalized anxiety disorder an anxiety or mood disorder? Considering multiple factors as we ponder the fate of GAD

Differential interactions between comorbid anxiety disorders and substance use disorder in rapid cycling bipolar I or II disorder

Contact Info

Product

Resources

About