Impact of comorbid anxiety disorders and obsessive-compulsive disorder on 24-month clinical outcomes of bipolar I disorder

Sung-Wan Kim, Lesley A Berk, Jayashri Kulkarni, Seetal Dodd, Rolet Anthony De Castella, Paul Bernard Fitzgerald, G Paul Amminger, Michael Berk

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30 Citations (Scopus)

Abstract

Background: This study investigated the impact of comorbid obsessive?compulsive disorder(OCD)and four anxiety disorders[panic disorder(PD),agoraphobia,social anxiety disorder(SAD),and generalized anxiety disorder(GAD)]on the clinical outcomes of bipolar disorder. Methods: This study analysed data of 174 patients with bipolar I disorder who participated in the prospective observational study. Participants were assessed every 3 months for 24 months.The primary outcome measure was the achievement of symptomatic remission,defined by a total score on the Young Mania Rating Scale(YMRS)of r12 and a total score on the 21-item Hamilton Depression Rating Scale (HAMD-21)of r8. Results: Comorbidity was associated with decreased likelihood of remission. However,the impact of individual disorders on outcome differed according to clinical and treatment situations. Most comorbid anxiety disorders and OCD had a negative effect on remission during the first year of evaluation, as measured by the HAMD-21,and inpatients taking a conventional mood stabilizer alone. However,the association with poorer outcome was observed only for a few specific comorbid disorders in the second year (GADandOCD), as measured by YMRS-defined remission(OCD), and inpatients with olanzapine therapy(GADandOCD). Limitations: Follow-up evaluation of comorbid disorders was lacking. Conclusions: Comorbid anxiety disorders and OCD negatively influenced the clinical course of bipolar disorder. Specifically,OCD had a consistently negative impact on the outcome of bipolar I disorder regardless of clinical situation. Effective strategies for the control of these comorbidities are required to achieve better treatment outcomes.
Original languageEnglish
Pages (from-to)243 - 248
Number of pages6
JournalJournal of Affective Disorders
Volume166
DOIs
Publication statusPublished - 2014

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