Impact of comorbid anxiety disorders on outcome in a cohort of patients with bipolar disorder.
Impact of comorbid anxiety disorders on outcome in a cohort of patients with bipolar disorder.
复制标题
共病焦虑症对双相情感障碍患者队列结果的影响。
DOI：
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发表时间：
2004
影响因子：
5.3
通讯作者：
G. MacQueen
中科院分区：
文献类型：
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作者：
K. Boylan;P. Bieling;M. Marriott;Helen Bégin;L. Young;G. MacQueen
背景
在双相情感障碍患者中，共病焦虑障碍的发生率很高。虽然焦虑症常与双相情感障碍并存是公认的，但很少有研究探讨1种以上焦虑症对双相情感障碍患者长期预后的影响。
方法
在1994年至1999年期间连续就诊的138例双相情感障碍患者中，采用结构化临床访谈法确定了DSM-IV广泛性焦虑障碍、惊恐障碍、社交恐怖症、强迫症和创伤后应激障碍的发病率。然后对患者进行长达3年的纵向临床监测。评估1种或多种共病焦虑障碍对情绪症状和一般功能的影响。
结果
在我们的样本中，55.8%的患者至少有1种共病焦虑症，31.8%的患者有2种或更多的焦虑症诊断。最常见的焦虑障碍是广泛性焦虑障碍，其次是惊恐障碍。焦虑障碍的存在导致总体和特定疾病指标的结果显著（p <0.05）更差，包括疾病严重程度、以情绪正常为特征的患者比例和患病年份比例。焦虑症的数量不如类型重要，广泛性焦虑症和社交恐惧症对结果的负面影响最大。
结论
我们的数据表明，在双相情感障碍中，多种焦虑障碍合并症并不少见，广泛性焦虑障碍和社交恐惧症更可能与不良结局相关。我们讨论了一些潜在的机制和影响，在我们的研究结果。
BACKGROUND
High rates of comorbid anxiety disorders have been described in individuals with bipolar disorder. Although it is well recognized that anxiety disorders often co-occur with bipolar disorder, few studies have examined the impact of more than 1 anxiety disorder on long-term outcome in patients with bipolar disorder.
METHOD
The rates of DSM-IV generalized anxiety disorder, panic disorder, social phobia, obsessive-compulsive disorder, and posttraumatic stress disorder were determined using structured clinical interviews in 138 patients with bipolar disorder who presented consecutively between 1994 and 1999. Patients were then followed for up to 3 years with longitudinal clinical surveillance. The impact of 1 or more comorbid anxiety disorders on mood symptoms and general function was evaluated.
RESULTS
In our sample, 55.8% of the patients had at least 1 comorbid anxiety disorder, and 31.8% had 2 or more anxiety disorder diagnoses. The most common anxiety disorder was generalized anxiety disorder, followed by panic disorder. The presence of an anxiety disorder led to significantly (p <.05) worse outcome on global as well as specific illness measures, including illness severity, proportion of patients characterized as euthymic, and proportion of the year spent ill. Number of anxiety disorders was less important than type, with generalized anxiety disorder and social phobia having the most negative impact on outcome.
CONCLUSION
Our data suggested that multiple anxiety disorder comorbidities were not infrequent in bipolar disorder and that generalized anxiety disorder and social phobia were more likely to be associated with poor outcome. We discuss some potential mechanisms and implications in our findings.