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Almeida VFD, Bezerra-Filho S, Studart-Bottó P, Léda-Rego G, Silva ITF, Kapczinski F, Miranda-Scippa Â. History of suicide attempts in patients with bipolar disorder type I: socio-demographic and clinical factors, quality of life and functioning. Nord J Psychiatry 2021; 75:306-313. [PMID: 33302763 DOI: 10.1080/08039488.2020.1853230] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
INTRODUCTION This study aims to evaluate sociodemographic and clinical factors, quality of life (QoL) and functioning associated with history of suicide attempts (SA) in a sample of bipolar disorder (BD) type I patients. METHODS A total of 417 BD type I patients, with and without history of SA were recruited from two Brazilian specialized Mood Disorder Centers. They were assessed with a sociodemographic and clinical questionnaire, the Young Mania Rating Scale, the Hamilton Depression Rating Scale, the Structured Clinical Interviews for DSM-IV Axis I Disorders, the World Health Organization Quality of Life-BREF, and the Sheehan Disability Scale. RESULTS One hundred and seventy-nine (42.9%) patients had a history of SA. There were no statistically significant sociodemographic differences between BD patients with and without a history of SA. Logistic regression found that lifetime hospitalization, comorbid anxiety disorders, depressive polarity in the first episode, current intensity of depressive symptoms, history of rapid cycling, family history of suicide and age at onset were significantly associated with SA in BD. Multiple linear regression showed that SA had no effect on QoL and functioning, which were affected mainly by comorbid anxiety disorders and current intensity of depressive symptoms, even in patients considered euthymic. CONCLUSION Suicidal behavior in patients with BD is a complex phenomenon and reflects a more severe course of illness. Patients with history of SA may have worse QoL and functional impairment not because of its direct effect, but because of the greater association with clinical factors related to poor prognosis.
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Affiliation(s)
| | | | - Paula Studart-Bottó
- Mood and Anxiety Disorders Program (CETHA), UFBA, Salvador, Brazil.,Postgraduate Program in Medicine and Health, UFBA, Salvador, Brazil
| | - Gabriela Léda-Rego
- Mood and Anxiety Disorders Program (CETHA), UFBA, Salvador, Brazil.,Postgraduate Program in Medicine and Health, UFBA, Salvador, Brazil
| | | | - Flávio Kapczinski
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Ângela Miranda-Scippa
- Mood and Anxiety Disorders Program (CETHA), UFBA, Salvador, Brazil.,Postgraduate Program in Medicine and Health, UFBA, Salvador, Brazil.,Department of Neurosciences and Mental Health, Bahia Medical School, UFBA, Salvador, Brazil
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Çörekçioğlu S, Cesur E, Devrim Balaban Ö. Relationship between impulsivity, comorbid anxiety and neurocognitive functions in bipolar disorder. Int J Psychiatry Clin Pract 2021; 25:62-72. [PMID: 33063587 DOI: 10.1080/13651501.2020.1833040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of the study is to examine the relationship between anxiety and impulsivity and to reveal the correlation of these variables with clinical and sociodemographic features. It is also aimed to investigate the relationship between impulsivity and anxiety with neurocognitive functions in bipolar disorder. METHODS The sample of the study comprises of 71 patients with bipolar disorder type I without any comorbidity (BD), 37 patients with anxiety disorder comorbidity with bipolar disorder type I (BDAD), 52 patients with anxiety disorder (AD) and 50 healthy controls (HC). Participants completed Barratt Impulsivity Scale-11, State-Trait Anxiety Inventory 1-2, Panic Disorder Severity Scale (PDSS), brief version of Fear of Negative Evaluation Scale (FNES), Anxiety Sensitivity Index-3 (ASI-3), Trail-Making Test A-B, Digit Span Test, Stroop Test. RESULTS PDSS scores, trait anxiety level, hypomanic and mixed episode numbers explain 26% of attention impulsivity. Gender and ASI-3 social dimensions explain 16% of motor impulsivity. Trait anxiety explains non-planning and total impulsivity at 26 and 24%, respectively. When neurocognitive impairment's effect was controlled, it was found AD and BDAD groups had higher impulsivity levels than the BD and HC groups. CONCLUSION Anxiety disorder comorbidity increases impulsivity in bipolar disorder.KEYPOINTSIn the presence of anxiety disorder spectrum comorbidity, bipolar disorder patients will have increased impulsivity and the clinical course may be more severe.Trait anxiety levels and anxiety sensitivity may be predictive factors for impulsivity.In the presence of anxiety disorder spectrum comorbidity, it should be taken into consideration that these patients may be more impulsive and should be treated with more care in terms of evaluation of the disorder.
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Affiliation(s)
| | - Ender Cesur
- The Council of Forensic Medicine, Istanbul, Turkey
| | - Özlem Devrim Balaban
- Bakırköy Research & Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
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Yapici Eser H, Kacar AS, Kilciksiz CM, Yalçinay-Inan M, Ongur D. Prevalence and Associated Features of Anxiety Disorder Comorbidity in Bipolar Disorder: A Meta-Analysis and Meta-Regression Study. Front Psychiatry 2018; 9:229. [PMID: 29997527 PMCID: PMC6030835 DOI: 10.3389/fpsyt.2018.00229] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 05/11/2018] [Indexed: 12/23/2022] Open
Abstract
Objective: Bipolar disorder is highly comorbid with anxiety disorders, however current and lifetime comorbidity patterns of each anxiety disorder and their associated features are not well studied. Here, we aimed to conduct a meta-analysis and meta-regression study of current evidence. Method: We searched PubMed to access relevant articles published until September 2015, using the keywords "Bipolar disorder" or "Affective Psychosis" or "manic depressive" separately with "generalized anxiety," "panic disorder," "social phobia," "obsessive compulsive," and "anxiety." Variables for associated features and prevalence of anxiety disorders were carefully extracted. Results: Lifetime any anxiety disorder comorbidity in BD was 40.5%; panic disorder (PD) 18.1%, generalized anxiety disorder (GAD) 13.3%, social anxiety disorder (SAD) 13.5% and obsessive compulsive disorder (OCD) 9.7%. Current any anxiety disorder comorbidity in BD is 38.2%; GAD is 15.2%, PD 13.3%, SAD 11.7%, and OCD 9.9%. When studies reporting data about comorbidities in BDI or BDII were analyzed separately, lifetime any anxiety disorder comorbidity in BDI and BDII were 38% and 34%, PD was 15% and 15%, GAD was 14% and 16.6%, SAD was 8% and 13%, OCD was 8% and 10%, respectively. Current any DSM anxiety disorder comorbidity in BDI or BDII were 31% and 37%, PD was 9% and 13%, GAD was 8% and 12%, SAD was 7% and 11%, and OCD was 8% and 7%, respectively. The percentage of manic patients and age of onset of BD tended to have a significant impact on anxiety disorders. Percentage of BD I patients significantly decreased the prevalence of panic disorder and social anxiety disorder. A higher rate of substance use disorder was associated with greater BD-SAD comorbidity. History of psychotic features significantly affected current PD and GAD. Conclusions: Anxiety disorder comorbidity is high in BD with somewhat lower rates in BDI vs BDII. Age of onset, substance use disorders, and percentage of patients in a manic episode or with psychotic features influences anxiety disorder comorbidity.
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Affiliation(s)
- Hale Yapici Eser
- School of Medicine, Koç University, Sariyer, Turkey.,Research Center for Translational Medicine, Koç University, Istanbul, Turkey
| | - Anil S Kacar
- Research Center for Translational Medicine, Koç University, Istanbul, Turkey
| | - Can M Kilciksiz
- School of Medicine, Koç University, Sariyer, Turkey.,Psychotic Disorders Division, McLean Hospital, Belmont, CA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | | | - Dost Ongur
- Psychotic Disorders Division, McLean Hospital, Belmont, CA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
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Serafini G, Geoffroy PA, Aguglia A, Adavastro G, Canepa G, Pompili M, Amore M. Irritable temperament and lifetime psychotic symptoms as predictors of anxiety symptoms in bipolar disorder. Nord J Psychiatry 2018; 72:63-71. [PMID: 29022840 DOI: 10.1080/08039488.2017.1385851] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE Affective temperaments, hopelessness, alexithymia, and anxiety/agitation symptoms may play a significant role in the psychopathological characteristics of bipolar disorder (BD). Here, we aimed to investigate the eventual association between the mentioned explanatory variables and anxiety/agitation symptoms in BD. MATERIALS AND METHODS We recruited at the Section of Psychiatry, Department of Neuroscience, University of Genoa (Italy), 92 BD inpatients having a mean age of 52 (±13.8) years. Participants were assessed using specific psychometric instruments. Anxiety/agitation symptoms have been evaluated using the 11-item of the Beck Depression Inventory II (BDI-II). RESULTS Overall, 53.8% of participants presented with anxiety/agitation symptoms and 46.2% without. The two groups significantly differed about socio-economic status, lifetime psychotic symptoms, and residual depressive symptoms between episodes. Anxiety/agitation symptoms significantly correlated with irritable affective temperament (r = 0.407; p = .01), hopelessness (r = 0.541; p ≤ .001), difficulty identifying feelings (r = 0.440; p ≤ .001), difficulty describing feelings (r = 0.437; p ≤ .001), and externally oriented-thinking (r = 0.393; p ≤ .001). After multivariate analyses, irritable affective temperament (OR = 2.457, p ≤ .01) and less lifetime psychotic symptoms (OR = 0.007, p ≤ .05) remained the only significant variables associated with anxiety/agitation symptoms. CONCLUSIONS The generalization of the main findings is limited by the small sample size and cross-sectional study design. Nevertheless, our results suggest that the careful assessment of affective temperaments and psychotic symptoms may help to early identify BD patients suffering from anxiety/agitation symptoms and may allow to perform targeted interventions in the clinical practice.
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Affiliation(s)
- Gianluca Serafini
- a Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry , University of Genoa , Genoa , Italy
| | - Pierre A Geoffroy
- b Sorbonne Paris Cité, UMR-S 1144 , Université Paris Diderot , Paris , France.,c Pôle de Psychiatrie et de Médecine Addictologique , AP-HP, GH Saint-Louis - Lariboisière - F. Widal , Paris , France
| | - Andrea Aguglia
- a Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry , University of Genoa , Genoa , Italy
| | - Giulia Adavastro
- a Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry , University of Genoa , Genoa , Italy
| | - Giovanna Canepa
- a Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry , University of Genoa , Genoa , Italy
| | - Maurizio Pompili
- d Department of Neuroscience , Suicide Prevention Center, Sant'Andrea Hospital, University of Rome , Rome , Italy
| | - Mario Amore
- a Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry , University of Genoa , Genoa , Italy
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