TY - JOUR
T1 - Impact of comorbid anxiety disorders and obsessive-compulsive disorder on 24-month clinical outcomes of bipolar I disorder
AU - Kim, Sung-Wan
AU - Berk, Lesley A
AU - Kulkarni, Jayashri
AU - Dodd, Seetal
AU - De Castella, Rolet Anthony
AU - Fitzgerald, Paul Bernard
AU - Amminger, G Paul
AU - Berk, Michael
PY - 2014
Y1 - 2014
N2 - 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.
AB - 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.
UR - http://www.ncbi.nlm.nih.gov/pubmed/25012437
U2 - 10.1016/j.jad.2014.05.017
DO - 10.1016/j.jad.2014.05.017
M3 - Article
SN - 0165-0327
VL - 166
SP - 243
EP - 248
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -