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

Gao, Keming; Tolliver, Bryan K.; Kemp, David E.; Verduin, Marcia L.; Ganocy, Stephen J.; Bilali, Sarah; Brady, Kathleen T.; Shim, Seong S.; Findling, Robert L.; Calabrese, Joseph R.

doi:10.1016/j.jad.2007.12.229

Cited by 23 publications

(28 citation statements)

References 21 publications

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“…The ECA study data showed that patients with bipolar I disorder had higher rates of SUD than those with bipolar II disorder. 7 Our previous analysis 27 in a larger sample of patients with rapid-cycling bipolar disorder also showed that patients with rapid-cycling bipolar I disorder had significantly higher rates of SUDs than those with rapid-cycling bipolar II disorder. Higher rates of comorbid SUDs in patients with bipolar I disorder (42%–78%) compared to those with bipolar II disorder (17%–48%) has been reported in other studies.…”

Section: Discussionmentioning

confidence: 91%

Clinical Correlates of Patients With Rapid-Cycling Bipolar Disorder and a Recent History of Substance Use Disorder

Gao¹,

Verduin²,

Kemp³

et al. 2008

J. Clin. Psychiatry

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Objective To compare clinical variables in patients with rapid-cycling bipolar I or II disorder and a recent history of substance use disorder (SUD). Method Cross-sectional data from 2 studies of patients with rapid-cycling bipolar I disorder or rapid-cycling bipolar II disorder and a recent history of SUD were used to retrospectively assess the differences in clinical variables between the subtypes. The studies were conducted from November 1997 to February 2007 at University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio. Extensive clinical interview and the Mini-International Neuropsychiatric Interview were used to ascertain DSM-IV diagnoses of rapid-cycling bipolar disorder, SUDs, and other Axis I disorders and to collect clinical variables. The Addiction Severity Index (ASI), Global Assessment Scale (GAS), and the Medical Outcomes Study 36-ltem Short-Form Health Survey were used to measure the severity of impairment at the initial assessment. One-way analysis of variance or χ2 was used for significance tests. A Bonferroni adjustment was applied for multiple comparisons. Results Of 245 patients with rapid-cycling bipolar disorder (rapid-cycling bipolar I disorder, N = 191; rapid-cycling bipolar II disorder, N = 54) and a recent history of SUD, the demographics were similar. A significantly higher rate of panic disorder was observed in patients with rapid-cycling bipolar I disorder than in those with rapid-cycling bipolar II disorder (odds ratio = 3.72, 95% CI = 1.66 to 8.32, p = .008). A significantly higher psychiatric composite score on the ASI was also found in patients with rapid-cycling bipolar I disorder than in those with rapid-cycling bipolar II disorder even after Bonferroni adjustment (p = .0007). There were no significant differences between the subtypes in the rates of previous hospitalization or suicide attempt, early childhood verbal, physical, or sexual abuse, lifetime substance abuse or dependence, the number of SUDs or mood episodes in the last 12 months, and total or other subscale scores on ASI and GAS. Conclusion Except for the significantly higher rate of comorbid panic disorder and higher psychiatric composite scores on the ASI in patients with rapid-cycling bipolar I disorder than in those with rapid-cycling bipolar II disorder, the other clinical variables were similar between the 2 groups.

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Section: Discussionmentioning

confidence: 91%

Clinical Correlates of Patients With Rapid-Cycling Bipolar Disorder and a Recent History of Substance Use Disorder

Gao¹,

Verduin²,

Kemp³

et al. 2008

J. Clin. Psychiatry

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“…A “recent” SUD was defined as having a diagnosis of substance dependence and continuing to meet abuse or dependence criteria for a substance(s) in the last 6 months at the time of initial assessment or having a diagnosis of substance abuse and continuing to abuse a substance(s) in the previous 3–6 months. The study design, inclusion and exclusion criteria, mood state at study entry, and the stage of each study at the time of this analysis are summarized elsewhere 19,23 …”

Section: Methodsmentioning

confidence: 99%

“…Previously, we found that the increased rates of GAD and panic disorder, but not obsessive compulsive disorder (OCD), only occurred in patients with rapid‐cycling bipolar I disorder (RCBDI) and co‐occurring SUDs, not in those with RCBDI without a history of SUDs or in those with rapid‐cycling bipolar II disorder (RCBDII) 19 . However, among patients with RCBD and a recent history of SUDs, patients with either subtype had more similarities than differences in the rates of historical clinical variables, the number of SUDs, scores on the addiction severity index, and scores of global assessment scale 20 .…”

Section: Introductionmentioning

confidence: 99%

Independent Predictors for Lifetime and Recent Substance Use Disorders in Patients with Rapid‐Cycling Bipolar Disorder: Focus on Anxiety Disorders

et al. 2010

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We set out to study independent predictor(s) for lifetime and recent substance use disorder (SUDs) in patients with rapid cycling bipolar disorder (RCBD). Extensive Clinical Interview and Mini International Neuropsychiatric Interview were used to ascertain DSM-IV Axis I diagnoses of RCBD, anxiety disorders, and SUDs. Data from patients enrolling into four similar clinical trials were used. Where appropriate, univariate analyses with t-test or Chi-Square were applied. Stepwise logistic regression was used to examine the relationship among predictor variables and lifetime and recent SUDs. Univariate analysis showed that patients with co-occurring anxiety disorders (n=261) had significantly increased rates of lifetime (OR=2.1) and recent (OR=1.9) alcohol dependence as well as lifetime (OR=3.4) and recent (OR=2.5) marijuana dependence compared to those without co-occurring anxiety disorder (n=303). In logistic regression analyses, Address correspondence to Dr. Gao, 10524 Euclid Avenue, 12 th floor, Cleveland, OH 44106. keming.gao@uhhospitals.org. Dr. Verduin is currently at the Department of Medical Education, University of Central Florida, College of Medicine in Orlando, Florida. Declaration of InterestDr. Gao receives or has received, acted as a consultant and/or served on a speaker's bureau for Abbott, AstraZeneca, Pfizer, ScheringPlough, and NARSAD. Dr. Verduin has received grant support from Bristol-Myers Squibb, Eli Lilly, and Janssen. Dr. Kemp serves on the speaker's bureau for Astra-Zeneca and Pfizer, and serves as a consultant for Bristol-Myers Squibb. He has received research support from Takeda (study medication only, no financial support), NARSAD, and the International Society NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript generalized anxiety disorder (GAD) was associated with increased risk for lifetime SUDs (OR=2.34), alcohol dependence (OR=1.73), and marijuana dependence (OR=3.36), and recent marijuana dependence (OR=3.28). A history of physical abuse was associated with increased risk for lifetime SUDs (OR=1.71) and recent marijuana dependence (OR=3.47). Earlier onset of first mania/hypomania was associated with increased risk for lifetime SUDs (5% per year) and recent marijuana dependence (12% per year) and later treatment with a mood stabilizer were also associated with increased risk for recent SUDs (8% per year). Positive associations between generalized anxiety disorder, later treatment with a mood stabilizer, and early childhood trauma and history of SUDs suggests that adequate treatment of comorbid anxiety, early treatment with a mood stabilizer, and prevention of childhood trauma may reduce the risk for the development of SUDs in patients with bipolar disorder.

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“…The relationship of comorbid anxiety with suicidality is questionable (Slama et al 2004 ). Probably it is more frequent in BD-II than in BD-I patients (Dittmann et al 2002 ), although rapid cycling and substance abuse might reverse this and dramatically increase anxiety rates in BD-I (Gao et al 2008 ).…”

Section: Comorbid Anxietymentioning

confidence: 99%

Comorbidity

Fountoulakis¹

2014

Bipolar Disorder

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

Cited by 23 publications

References 21 publications

Clinical Correlates of Patients With Rapid-Cycling Bipolar Disorder and a Recent History of Substance Use Disorder

Clinical Correlates of Patients With Rapid-Cycling Bipolar Disorder and a Recent History of Substance Use Disorder

Independent Predictors for Lifetime and Recent Substance Use Disorders in Patients with Rapid‐Cycling Bipolar Disorder: Focus on Anxiety Disorders

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