Differences in Axis I and II Comorbidity Between Bipolar I and II Disorders and Major Depressive Disorder

Mantere, Outi; Melartin, Tarja; Suominen, Kirsi; Rytsälä, Heikki; Valtonen, Hannu; Arvilommi, Petri; Leppämäki, Sami; Isometsä, Erkki

doi:10.4088/jcp.v67n0409

Cited by 86 publications

(78 citation statements)

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“…Fan & Hassell developed the hypothesis that, due to the similarity of some symptoms, cluster B disorders are more commonly found in bipolar patients than clusters A and C. 11 Regardless of the instruments used and the symptomatic state in which patients are evaluated, cluster B disorders remain those most frequently reported. 22,27,33,34 In our review, 87 patients (23%) belonged to this cluster, confirming the existing literature.…”

Section: Discussionsupporting

confidence: 89%

“…Further examination of these articles was performed and yielded a final sample of three eligible articles. The remaining nine articles were excluded because they did not meet the inclusion criteria: four studies mixed inpatients and outpatients 10,[26][27][28] ; two included only hospitalized patients 20,22 ; and the remaining three included outpatients, but not all were in euthymia. [29][30][31] Most of the studies used diagnostic scales other than HAM-D and YMRS, and some used none at all (Figure 1).…”

Section: Resultsmentioning

confidence: 99%

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Personality disorders in euthymic bipolar patients: a systematic review

Bezerra-Filho

Almeida

Studart

et al. 2015

Rev. Bras. Psiquiatr.

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Objective: To identify, by means of a systematic review, the frequency with which comorbid personality disorders (PDs) have been assessed in studies of euthymic bipolar patients. Methods: PubMed, SciELO and PsychINFO databases were searched for eligible articles published between 1997 and 2013. After screening 1,249 empirical papers, two independent reviewers identified three articles evaluating the frequency of PDs in patients with bipolar disorders assessed in a state of euthymia.Results: The total sample comprised 376 euthymic bipolar patients, of whom 155 (41.2%) had at least one comorbid PD. Among them, we found 87 (23.1%) in cluster B, 55 (14.6%) in cluster C, and 25 (6.6%) in cluster A. The frequencies of PD subtypes were: borderline, 38 (10.1%); histrionic, 29 (7.7%); obsessive-compulsive, 28 (7.4%); dependent, 19 (5%); narcissistic, 17 (4.5%); schizoid, schizotypal, and avoidant, 11 patients each (2.95%); paranoid, five (1.3%); and antisocial, three (0.79%). Conclusion: The frequency of comorbid PD was high across the spectrum of euthymic bipolar patients. In this population, the most common PDs were those in cluster B, and the most frequent PD subtype was borderline, followed by histrionic and obsessive-compulsive.

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Section: Discussionsupporting

confidence: 89%

Section: Resultsmentioning

confidence: 99%

Personality disorders in euthymic bipolar patients: a systematic review

Bezerra-Filho

Almeida

Studart

et al. 2015

Rev. Bras. Psiquiatr.

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“…Previous studies measuring affective instability using the ALS have suggested both bipolar disorder II and borderline personality disorder involve similar levels of affective lability, though there are differential patterns in the two disorders (Henry et al, 2001;Reich et al, 2012). Whilst we did not have a borderline personality disorder comparison group our results may in part be explained by comorbidity with borderline personality disorder, which is known to exist in 25-30% of people with bipolar disorders being highest in bipolar II (Mantere et al, 2006). These results may help to explain the difficulties that clinicians have in delineating bipolar disorder II and borderline personality disorder.…”

Section: Theoretical and Clinical Implicationsmentioning

confidence: 87%

Affective instability, childhood trauma and major affective disorders

Marwaha

Gordon‐Smith

Broome

et al. 2016

Journal of Affective Disorders

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“…Es posible que en esta muestra exista un sobrediagnóstico de TB por haber diagnosticado como tales a pacientes que presentan cambios del estado anímico propias de su TUS o TP, e igualmente puede existir un sobrediagnóstico de TP en esta muestra por el instrumento utilizado, de cualquier forma el hecho de realizarse una entrevista estructurada puede minimizar ese sesgo e, igualmente, se ha referido que reconociendo la dificultad diagnóstica que conlleva estos cuadros y la necesidad de la realización de un adecuado diagnóstico diferencial entre las manifestaciones afectivas y conductuales de los TB, TP y TUS, la comorbilidad entre estos cuadros es habitual con otros TP u otros trastornos del eje I como los trastornos de ansiedad (Bauer et al, 2005;Merikangas et al, 2007;Mantere et al, 2006;Merikangas et al, 2011;Mazza et al, 2009). Así la comorbilidad del TB con TP como puede ser el trastorno límite se asocia con un mayor riesgo de TUS (Hidalgo-Mazzei, Walsh, Rosenstein y Zimmerman, 2015).…”

Section: Discussionunclassified

Trastorno bipolar y trastorno por uso de sustancias. Estudio Madrid sobre prevalencia de patología dual

Arias¹,

Szerman²,

Vega³

et al. 2016

Adicciones

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adicciones vol. 29, nº 3 · 2017Given its prevalence and impact on public health, the comorbidity of bipolar and substance use disorders is one of the most relevant of dual diagnoses. The objective was to evaluate the characteristics of patients from community mental health and substance abuse centres in Madrid. The sample consisted of 837 outpatients from mental health and substance abuse centres. We used the Mini International Neuropsychiatric Interview (MINI) and Personality Disorder Questionnaire (PDQ4+) to evaluate axis I and II disorders. Of these patients, 174 had a lifetime bipolar disorder, 83 had bipolar disorder type I and 91 had type II. Most patients had dual pathology. Of the 208 participants from the mental health centres, 21 had bipolar disorder and 13 (61.9%) were considered dually-diagnosed patients, while 33.2% of non-bipolar patients had a dual diagnoses (p = 0.03).Of the 629 participants from the substance abuse centres, 153 patients (24.3%) had a bipolar diagnosis. Bipolar dual patients had higher rates of alcohol and cocaine dependence than non-bipolar patients. Moreover, age at onset of alcohol use was earlier in bipolar duallydiagnosed patients than in other alcoholics. Bipolar dually-diagnosed patients had higher personality and anxiety disorder comorbidities and greater suicide risk. Thus, alcohol and cocaine are the drugs most associated with bipolar disorder. Given the nature of the study, the type of relationship between these disorders cannot be determined. La comorbilidad entre trastorno bipolar y trastorno por uso de sustancias (TUS) es de las más relevantes dentro del espectro de la patología dual por su prevalencia y sus repercusiones evolutivas y sociosanitarias. Nuestro objetivo fue estudiar las características de los pacientes con diagnóstico de trastorno bipolar y trastorno por uso de sustancias procedentes del Estudio Madrid sobre prevalencia de patología dual en sujetos en tratamiento en el servicio sanitario público. KeywordsLa muestra procede de pacientes en tratamiento en las redes públicas de salud mental y de tratamiento para las adicciones de la Comunidad de Madrid. Los sujetos fueron evaluados con la entrevista Mini International Neuropsychiatric Interview (MINI) para el diagnóstico de los trastornos mentales y con la escala Personality Disorder Questionnaire (PDQ) para el diagnóstico de los trastornos de personalidad. De los 837 pacientes incluidos, 174 tenían un diagnóstico a lo largo de la vida de trastorno bipolar, 83 con trastorno bipolar tipo I y 91 del tipo II. La mayoría de ellos tenían algún diagnóstico de TUS. En la red de salud mental, de los 208 participantes, 21 tenían un diagnóstico de trastorno bipolar, de estos el 13 (61.9%) tenían un diagnóstico de TUS y se consideraron duales, mientras que en el resto de los pacientes de salud mental el 33.2% tenían un diagnóstico comórbido de TUS (p = 0.03). En los centros de drogas, de los 629 pacientes valorados, un 24.3% (n = 153) tenían un diagnóstico de trastorno bipolar. El subgrupo de pacientes con trastorn...

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Differences in Axis I and II Comorbidity Between Bipolar I and II Disorders and Major Depressive Disorder

Cited by 86 publications

References 0 publications

Personality disorders in euthymic bipolar patients: a systematic review

Personality disorders in euthymic bipolar patients: a systematic review

Affective instability, childhood trauma and major affective disorders

Trastorno bipolar y trastorno por uso de sustancias. Estudio Madrid sobre prevalencia de patología dual

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