Lifetime prevalence of anxiety disorders in people with bipolar disorder: a systematic review and meta-analysis

Pavlová, Barbara; Perlis, Roy H.; Alda, Martin; Uher, Rudolf

doi:10.1016/s2215-0366(15)00112-1

Cited by 125 publications

(97 citation statements)

References 45 publications

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“…Our findings are also consistent with previous studies that have noted the high comorbidity of anxiety disorders in BD (Bauer et al, 2005; Otto et al, 2006; Pavlova et al, 2015). In the context of BD, anxiety is associated with a more severe course of illness (Boylan et al, 2004), including an earlier age at onset (Bauer et al, 2005) and increased suicide ideation and attempt (Dilsaver et al, 2006; Schaffer et al, 2015; Young et al, 1993).…”

Section: Discussionsupporting

confidence: 93%

Factor analysis of temperament and personality traits in bipolar patients: Correlates with comorbidity and disorder severity

Qiu

Akiskal

Kelsoe

et al. 2017

Journal of Affective Disorders

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Background Temperament and personality traits have been suggested as endophenotypes for bipolar disorder based on several lines of evidence, including heritability. Previous work suggested an anxious-reactive factor identified across temperament and personality inventories that produced significant group discrimination and could potentially be useful in genetic analyses. We have attempted to further characterize this factor structure in a sample of bipolar patients. Methods A sample of 1195 subjects with bipolar I disorder was evaluated, all with complete data available. Dimension reduction across two inventories identified 18 factors explaining 39% of the variance. Results The two largest factors reflected affective instability and general anxiety/worry, respectively. Subsequent analyses of the clinical features associated with bipolar disorder revealed specificity for the factors in a predictable pattern. Cluster analysis of the factors identified a subgroup defined by a strong lack of general anxiety and low affective instability represented by the first two factors. The remaining subjects could be distinguished into two clusters by the presence of either more positive characteristics, including persistence/drive, spirituality, expressivity, and humor, or more negative characteristics of depression and anxiety. Limitations These analyses involved bipolar I subjects only and must be extended to other bipolar spectrum diagnoses, unaffected relatives, and individuals at risk. Conclusions These results suggest that temperament and personality measures access latent traits associated with important clinical features of bipolar disorder. By translating clinical variables into quantitative traits, we may identify subgroups of bipolar patients with distinct clinical profiles, thereby facilitating both individual treatment strategies and genetic analyses.

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Section: Discussionsupporting

confidence: 93%

Factor analysis of temperament and personality traits in bipolar patients: Correlates with comorbidity and disorder severity

Qiu

Akiskal

Kelsoe

et al. 2017

Journal of Affective Disorders

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“…In lieu of looking across phenotypes, a recent report describes a method to identify disease subtypes based upon network analysis (29). Our approach is each of the 50 topics, a total of 56 loci spanning 24 topics included at least one SNP with p < 1e-11; 39 of these loci across 22 topics included at least one additional associated SNP at p < 0.01.…”

Section: Discussionmentioning

confidence: 99%

Efficient Genome-wide Association in Biobanks Using Topic Modeling Identifies Multiple Novel Disease Loci

McCoy

Castro

Snapper

et al. 2017

Mol Med

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“…People with BP have depressive symptoms for a substantial proportion of the time4,5,41 and anxiety often co-occurs with the depression,12,42 resulting in long-term nonresponse 13. Our study results showed that anxiety symptoms improved only slightly in patients both with combination therapy with ADs and with LTG monotherapy, suggesting that the use of ADs may not affect the improvement of anxiety symptoms in bipolar patients.…”

Section: Discussionmentioning

confidence: 58%

“…However, it has been suggested that ADs may increase the risk of manic induction and cycle acceleration 9–11. Furthermore, both anxiety disorder comorbidity, which has a lifetime prevalence of 45% in individuals with BPs,12 and exposure to a greater number of AD trials have been suggested as independent predictors of prospective long-term nonresponse to treatment 13. In addition, a recent study on predictors of nonadherence among patients with mood disorders reveals that substance use disorder and illness severity are significant predictors of nonadherence especially in patients with BP, whereas treatment side effects are of primary importance for depressive disorder 14…”

Section: Introductionmentioning

confidence: 99%

Long-term efficacy and safety of lamotrigine for all types of bipolar disorder

Watanabe¹,

Hongō²

2017

NDT

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BackgroundWe investigated whether the long-term efficacy and safety of lamotrigine (LTG) for bipolar disorder (BP) differs between disease types (BP-I, BP-II, or BP not otherwise specified [BP-NOS]), and the efficacy of the concomitant use of antidepressants (ADs).MethodsFor >1 year, we observed 445 outpatients with BP (diagnosed by DSM-IV criteria) who initiated LTG treatment between July 1 and October 31, 2011, using the Himorogi Self-rating Depression (HSDS) and Anxiety Scales and the Clinical Global Impression-Improvement scale and also recorded adverse events.ResultsTreatment efficacy was observed at week 4, with the improved HSDS scores sustained until week 52 for all types of BP; 50% of the patients with any type of BP could be treated with LTG for 1 year, whereas ~40% could be treated for >1.5 years. However, 25% of the patients were withdrawn within the first 4 weeks. The overall incidence of adverse events was 22.9% (104/455): 34.1% (14/41) for BP-I, 22.7% (15/66) for BP-II, and 22.2% (75/338) for BP-NOS. The most common adverse event was skin rash: 22.0% for BP-I, 16.7% for BP-II, and 12.1% for BP-NOS.LimitationsThere was no control group. Data were collected retrospectively.ConclusionWith careful and adequate titration, long-term treatment with LTG is possible for any type of BP, with BP-NOS patients, the largest population in clinical practice, responding particularly well. Symptoms can improve with or without ADs. Large-scale prospective studies of the efficacy of ADs in bipolar treatment are warranted.

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Lifetime prevalence of anxiety disorders in people with bipolar disorder: a systematic review and meta-analysis

Cited by 125 publications

References 45 publications

Factor analysis of temperament and personality traits in bipolar patients: Correlates with comorbidity and disorder severity

Factor analysis of temperament and personality traits in bipolar patients: Correlates with comorbidity and disorder severity

Efficient Genome-wide Association in Biobanks Using Topic Modeling Identifies Multiple Novel Disease Loci

Long-term efficacy and safety of lamotrigine for all types of bipolar disorder

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