The role of lifetime anxiety history in the course of bipolar spectrum disorders

• Published in: Psychiatry research Vol. 264; pp. 202 - 209
• Main Authors: Titone, Madison K., Freed, Rachel D., O'Garro-Moore, Jared K., Gepty, Andrew, Ng, Tommy H., Stange, Jonathan P., Abramson, Lyn Y., Alloy, Lauren B.
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.06.2018
• Subjects: Adolescent; Adult; Anxiety disorder; Anxiety Disorders - psychology; Bipolar disorder; Bipolar Disorder - psychology; Comorbidity; Cyclothymic Disorder - psychology; Depression; Depressive Disorder, Major - psychology; Diagnostic and Statistical Manual of Mental Disorders; Female; Humans; Hypomania; Male; Mood disorders; Prospective Studies; Regression Analysis; Time Factors; Young Adult; Mood disorders; Bipolar disorder; Depression; Comorbidity; Hypomania; Anxiety disorder
• ISSN: 0165-1781; 1872-7123; 1872-7123
• DOI: 10.1016/j.psychres.2018.03.087

•Lifetime anxiety comorbidity in bipolar spectrum disorders was examined.•Main analyses consisted of negative binomial regression and Cox regression.•Anxiety history was associated with greater illness severity at baseline.•Anxiety history predicted a greater likelihood of prospective major depression.•Anxiety history predicted a lesser likelihood of prospective (hypo)mania. Individuals with bipolar spectrum disorder (BSD) frequently meet criteria for comorbid anxiety disorders, and anxiety may be an important factor in the etiology and course of BSDs. The current study examined the association of lifetime anxiety disorders with prospective manic/hypomanic versus major depressive episodes. Participants were 244 young adults (aged 17–26) with milder forms of BSDs (i.e., bipolar-II, cyclothymia, BD-NOS). First, bivariate analyses assessed differences in baseline clinical characteristics between participants with and without DSM-IV anxiety diagnoses. Second, negative binomial regression analyses tested whether lifetime anxiety predicted number of manic/hypomanic or major depressive episodes developed during the study. Third, survival analyses evaluated whether lifetime anxiety predicted time to onset of manic/hypomanic and major depressive episodes. Results indicated that anxiety history was associated with greater illness severity at baseline. Over follow-up, anxiety history predicted fewer manic/hypomanic episodes, but did not predict number of major depressive episodes. Anxiety history also was associated with longer time to onset of manic/hypomanic episodes, but shorter time to onset of depressive episodes. Findings corroborate past studies implicating anxiety disorders as salient influences on the course of BSDs. Moreover, results extend prior research by indicating that anxiety disorders may be linked with reduced manic/hypomanic phases of illness.