Anxiety disorder comorbidity in bipolar disorder patients: Data from the first 500 participants in the systematic treatment enhancement program for bipolar disorder (STEP-BD)
Anxiety disorder comorbidity in bipolar disorder patients: Data from the first 500 participants in the systematic treatment enhancement program for bipolar disorder (STEP-BD)
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DOI：
10.1176/appi.ajp.161.12.2222
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发表时间：
2004-12-01
影响因子：
17.7
通讯作者：
Pollack, MH
中科院分区：
文献类型：
--
作者：
Simon, NM;Otto, MW;Pollack, MH
目的：作者提供了一个详细的角度对相关的共病焦虑在一个大的，良好的特征样本的双相情感障碍患者。方法：焦虑及其相关因素在来自参加双相障碍系统治疗增强计划的前500名双相I型或双相II型患者的横断面样本中进行了检查，一个由国家精神卫生研究所资助的多中心项目，旨在评估双相情感障碍患者的纵向结果。终生共病焦虑障碍是常见的，发生在超过一半的样本中，并且与发病年龄较小，康复可能性降低，更差的角色功能和生活质量，更少的时间euthymic，更大的自杀企图的可能性。虽然物质滥用障碍在焦虑症患者中特别普遍，但共病焦虑似乎对功能产生独立的有害影响，包括自杀企图史（比值比=2.45，95% CI=1.4-4.2）。在双相情感障碍患者中，共病焦虑与更严重的程度和损害有独立的相关性，强调需要更多的临床关注，在这一人群中的焦虑，特别是加强自杀倾向的临床监测。此外，确定焦虑症状的有效治疗是否可以减轻双相情感障碍的严重程度，改善对躁狂或抑郁症状治疗的反应，或减少自杀倾向也很重要。
Objective: The authors provide a detailed perspective on the correlates of comorbid anxiety in a large, well-characterized sample of bipolar disorder patients.Method: Anxiety and its correlates were examined in a cross-sectional sample from the first 500 patients with bipolar I or bipolar II disorder enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder, a multicenter project funded by the National Institute of Mental Health designed to evaluate the longitudinal outcome of patients with bipolar disorder.Results: Lifetime comorbid anxiety disorders were common, occurring in over one-half of the sample, and were associated with younger age at onset, decreased likelihood of recovery, poorer role functioning and quality of life, less time euthymic, and greater likelihood of suicide attempts. Although substance abuse disorders were particularly prevalent among patients with anxiety disorders, comorbid anxiety appeared to exert an independent, deleterious effect on functioning, including history of suicide attempts (odds ratio=2.45, 95% CI=1.4-4.2).Conclusions: An independent association of comorbid anxiety with greater severity and impairment in bipolar disorder patients was demonstrated, highlighting the need for greater clinical attention to anxiety in this population, particularly for enhanced clinical monitoring of suicidality. in addition, it is important to determine whether effective treatment of anxiety symptoms can lessen bipolar disorder severity, improve response to treatment of manic or depressive symptoms, or reduce suicidality.