Co-morbid anxiety disorders in bipolar disorder and major depression: familial aggregation and clinical characteristics of co-morbid panic disorder, social phobia, specific phobia and obsessive-compulsive disorder

BackgroundCo-morbidity of mood and anxiety disorders is common and often associated with greater illness severity. This study investigates clinical correlates and familiality of four anxiety disorders in a large sample of bipolar disorder (BP) and major depressive disorder (MDD) pedigrees.MethodThe sample comprised 566 BP families with 1416 affected subjects and 675 MDD families with 1726 affected subjects. Clinical characteristics and familiality of panic disorder, social phobia, specific phobia and obsessive-compulsive disorder (OCD) were examined in BP and MDD pedigrees with multivariate modeling using generalized estimating equations.ResultsCo-morbidity between mood and anxiety disorders was associated with several markers of clinical severity, including earlier age of onset, greater number of depressive episodes and higher prevalence of attempted suicide, when compared with mood disorder without co-morbid anxiety. Familial aggregation was found with co-morbid panic and OCD in both BP and MDD pedigrees. Specific phobia showed familial aggregation in both MDD and BP families, although the findings in BP were just short of statistical significance after adjusting for other anxiety co-morbidities. We found no evidence for familiality of social phobia.ConclusionsOur findings suggest that co-morbidity of MDD and BP with specific anxiety disorders (OCD, panic disorder and specific phobia) is at least partly due to familial factors, which may be of relevance to both phenotypic and genetic studies of co-morbidity.

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Insight in patients with bipolar disorder with comorbid panic disorder, social phobia and obsessive compulsive disorder

European Neuropsychopharmacology ◽

10.1016/s0924-977x(01)80548-4 ◽

2001 ◽

Vol 11 ◽

pp. S361

Author(s):

S. Pini ◽

L. Dell'Osso ◽

X.F. Amador ◽

F. Soldani ◽

C. Mastrocinque ◽

...

Keyword(s):

Bipolar Disorder ◽

Panic Disorder ◽

Social Phobia ◽

Obsessive Compulsive Disorder ◽

Obsessive Compulsive ◽

Compulsive Disorder

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Construcción de una nueva escala en español para medir ansiedad.

Revista de Neuro-Psiquiatria ◽

10.20453/rnp.v74i2.1680 ◽

2013 ◽

Vol 74 (2) ◽

pp. 230-241

Author(s):

Johann Vega Dienstmaier

Keyword(s):

Panic Disorder ◽

Anxiety Disorders ◽

Social Phobia ◽

Psychiatric Patients ◽

Factorial Structure ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Different Types ◽

Frequent Items ◽

Selection Of

Objective: To construct a scale to evaluate the symptomatology of the different types of anxiety disorders. Materialand Method: After reviewing 25 instruments that assess nonspecific anxiety, generalized anxiety disorder (GAD),panic disorder, agoraphobia and other phobias, social phobia, obsessive-compulsive-disorder (OCD) and posttraumaticstress disorder (PTSD), new items were created and ordered according to the different types of anxiety symptomsand then on the frequency which its content appeared in the reviewed scales. Later, a scale was generated alternatingitems of different anxiety types beginning with the most frequent items of each category. Results: A new anxietyscale of 130 items was created (25 of nonspecific anxiety, 19 of GAD, 33 of panic disorder, agoraphobia and otherphobias, 29 of social phobia, 11 of OCD, and 13 of PTSD). Conclusions: This is the first step to create this newanxiety scale. Its application to healthy subjects and psychiatric patients with and without anxiety disorders toevaluate its psychometric features (factorial structure, internal consistency and validity), and later the modification,deletion and selection of items to generate a simpler and more useful scale, are pending.

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Obsessive–compulsive disorder, tics and anxiety in 6-year-old twins

Psychological Medicine ◽

10.1017/s0033291706008816 ◽

2006 ◽

Vol 37 (1) ◽

pp. 39-48 ◽

Cited By ~ 45

Author(s):

DEREK BOLTON ◽

FRÜHLING RIJSDIJK ◽

THOMAS G. O'CONNOR ◽

SEAN PERRIN ◽

THALIA C. ELEY

Keyword(s):

Anxiety Disorders ◽

Obsessive Compulsive Disorder ◽

Early Onset ◽

Familial Aggregation ◽

Community Sample ◽

Second Phase ◽

Obsessive Compulsive ◽

Two Phase ◽

Compulsive Disorder ◽

Co Morbidity

Background. Previous reports of genetic influences on obsessive–compulsive disorder (OCD) symptoms have suggested moderate heritability. Family history studies of co-morbidity have found familial aggregation with tics, especially for early-onset OCD, and familial aggregation with anxiety disorders.Method. Heritability of OCD and familial aggregation of OCD, tics and anxiety disorders were investigated in a community sample of 6-year-old twins using a two-phase design in which 4662 twin pairs were sampled and 854 pairs were assessed in the second phase by maternal-informant diagnostic interview using DSM-IV criteria.Results. In the multivariate model combined additive genetic and common environmental effects were estimated as 47% for sub-threshold OCD, and the model was unable to distinguish these sources of familial aggregation. There were strong familial aggregations between sub-threshold OCD and tics and between sub-threshold OCD and other anxiety disorders (80% and 97% respectively), although again specific sources could not be distinguished.Conclusions. The findings are consistent with the hypothesis of a tic-related early-onset OCD phenotype, but also with the hypothesis of an anxiety-related early-onset OCD phenotype.

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Hassle Faced with Induced Mania in Elderly Female While Treating for OC Symptoms. A Case Report.

10.21203/rs.3.rs-48060/v1 ◽

2020 ◽

Author(s):

POONAM BHARTI ◽

Angad harshbir singh ◽

Parul Gupta

Keyword(s):

Bipolar Disorder ◽

Case Report ◽

Index Case ◽

Opportunity To Learn ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Elderly Female ◽

Co Morbidity ◽

The Common ◽

Treatment Aspect

Abstract Background- Obsessive-compulsive disorder (OCD) is one of the most frequently associated comorbidities in bipolar disorder (BD). While this presents a challenge in understanding the phenomenology and also the treatment aspect of co occurrence of mania with OCD. Case history- The index case is of an elderly female who presented with OC symptoms and while on treatment had mania episodes. The mania episodes presented challenges while managing underlying OC symptoms. Conclusion- The common neurobiological mechanism for the co-morbid illness and treatment lacunae are discussed. The serotonin, dopamine, and glutamate having important role in BD-OCD were evaluated to understand the neurobiological basis of BD-OCD. The index case presented with the challenge of understanding the phenomenology of the illness but also presented with opportunity to learn and successfully manage patients with such co-morbidity. Divalproex and risperidone combo was found to be effective in controlling mania in OCD patients.

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Obsessive–compulsive disorder: subclassification based on co-morbidity

Psychological Medicine ◽

10.1017/s0033291708004753 ◽

2008 ◽

Vol 39 (9) ◽

pp. 1491-1501 ◽

Cited By ~ 60

Author(s):

G. Nestadt ◽

C. Z. Di ◽

M. A. Riddle ◽

M. A. Grados ◽

B. D. Greenberg ◽

...

Keyword(s):

Anxiety Disorder ◽

Obsessive Compulsive Disorder ◽

Clinical Characteristics ◽

Latent Class ◽

Age At Onset ◽

Separation Anxiety Disorder ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Co Morbidity ◽

The Relationship

BackgroundObsessive–compulsive disorder (OCD) is probably an etiologically heterogeneous condition. Many patients manifest other psychiatric syndromes. This study investigated the relationship between OCD and co-morbid conditions to identify subtypes.MethodSeven hundred and six individuals with OCD were assessed in the OCD Collaborative Genetics Study (OCGS). Multi-level latent class analysis was conducted based on the presence of eight co-morbid psychiatric conditions [generalized anxiety disorder (GAD), major depression, panic disorder (PD), separation anxiety disorder (SAD), tics, mania, somatization disorders (Som) and grooming disorders (GrD)]. The relationship of the derived classes to specific clinical characteristics was investigated.ResultsTwo and three classes of OCD syndromes emerge from the analyses. The two-class solution describes lesser and greater co-morbidity classes and the more descriptive three-class solution is characterized by: (1) an OCD simplex class, in which major depressive disorder (MDD) is the most frequent additional disorder; (2) an OCD co-morbid tic-related class, in which tics are prominent and affective syndromes are considerably rarer; and (3) an OCD co-morbid affective-related class in which PD and affective syndromes are highly represented. The OCD co-morbid tic-related class is predominantly male and characterized by high conscientiousness. The OCD co-morbid affective-related class is predominantly female, has a young age at onset, obsessive–compulsive personality disorder (OCPD) features, high scores on the ‘taboo’ factor of OCD symptoms, and low conscientiousness.ConclusionsOCD can be classified into three classes based on co-morbidity. Membership within a class is differentially associated with other clinical characteristics. These classes, if replicated, should have important implications for research and clinical endeavors.

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Cross-Cultural Approach to Anxiety Disorders

Social Behavior and Personality An International Journal ◽

10.2224/sbp.2010.38.6.759 ◽

2010 ◽

Vol 38 (6) ◽

pp. 759-760

Author(s):

William Eysenck ◽

Michael W. Eysenck

Keyword(s):

Anxiety Disorders ◽

Social Phobia ◽

Obsessive Compulsive Disorder ◽

Personal Responsibility ◽

Empirical Support ◽

Cross Cultural ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Cultural Approach ◽

Cross Cultural Differences

In his theory of anxiety disorders, Eysenck (1997) argued that focus on one's own behavior is associated with social phobia, whereas focus on future-oriented threat cognitions is associated with obsessive-compulsive disorder. These foci occur in part because social phobics tend to be introverted and obsessive-compulsives either perceive themselves as having onerous responsibilities or actually do have them (e.g., women with infants). These assumptions have empirical support (Eysenck). We can use the theory to predict cross-cultural differences in anxiety disorders. Social phobia should be more common in introverted cultures. We correlated lifetime incidence of social phobia (data: Wittchen & Fehm, 2001) with extraversion (data: Steel & Ones, 2002) across several countries, obtaining the predicted negative correlation (-0.35). We will expand the database to establish definitively the strength of this association. We will also explore the prediction that people in individualistic countries (emphasizing personal responsibility) have a higher incidence of obsessive-compulsive disorder than those in collectivistic countries, a prediction receiving preliminary support (e.g., Essau, Sakano, Ishikawa, & Sasagawa, 2004).

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Co-morbidity and familial aggregation of alcoholism and anxiety disorders

Psychological Medicine ◽

10.1017/s0033291798006941 ◽

1998 ◽

Vol 28 (4) ◽

pp. 773-788 ◽

Cited By ~ 209

Author(s):

K. R. MERIKANGAS ◽

D. E. STEVENS ◽

B. FENTON ◽

M. STOLAR ◽

S. O'MALLEY ◽

...

Keyword(s):

Anxiety Disorders ◽

Alcohol Dependence ◽

Social Phobia ◽

Familial Aggregation ◽

Familial Risk ◽

Family History Information ◽

Self Medication ◽

Co Morbidity ◽

History Information ◽

Familial Risk Factors

Background. This study examined the patterns of familial aggregation and co-morbidity of alcoholism and anxiety disorders in the relatives of 165 probands selected for alcoholism and/or anxiety disorders compared to those of 61 unaffected controls.Methods. Probands were either selected from treatment settings or at random from the community. DSM-III-R diagnoses were obtained for all probands and their 1053 first-degree relatives, based on direct interview or family history information.Results. The findings indicate that: (1) alcoholism was associated with anxiety disorders in the relatives, particularly among females; (2) both alcoholism and anxiety disorders were highly familial; (3) the familial aggregation of alcoholism was attributable to alcohol dependence rather than to alcohol abuse, particularly among male relatives; and (4) the pattern of co-aggregation of alcohol dependence and anxiety disorders in families differed according to the subtype of anxiety disorder; there was evidence of a partly shared diathesis underlying panic and alcoholism, whereas social phobia and alcoholism tended to aggregate independently.Conclusions. The finding that the onset of social phobia tended to precede that of alcoholism, when taken together with the independence of familial aggregation of social phobia and alcoholism support a self-medication hypothesis as the explanation for the co-occurrence of social phobia and alcoholism. In contrast, the lack of a systematic pattern in the order of onset of panic and alcoholism among subjects with both disorders as well as evidence for shared underlying familial risk factors suggests that co-morbidity between panic disorder and alcoholism is not a consequence of self-medication of panic symptoms. The results of this study emphasize the importance of examining co-morbid disorders and subtypes thereof in identifying sources of heterogeneity in the pathogenesis of alcoholism.

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Differential Response to Placebo Among Patients With Social Phobia, Panic Disorder, and Obsessive-Compulsive Disorder

American Journal of Psychiatry ◽

10.1176/appi.ajp.161.8.1485 ◽

2004 ◽

Vol 161 (8) ◽

pp. 1485-1487 ◽

Cited By ~ 43

Author(s):

Jonathan D. Huppert ◽

Luke T. Schultz ◽

Edna B. Foa ◽

David H. Barlow ◽

Jonathan R.T. Davidson ◽

...

Keyword(s):

Panic Disorder ◽

Social Phobia ◽

Obsessive Compulsive Disorder ◽

Differential Response ◽

Obsessive Compulsive ◽

Compulsive Disorder

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Anxiety disorders and the onset of depression among adults in the community

Psychological Medicine ◽

10.1017/s0033291702005482 ◽

2002 ◽

Vol 32 (6) ◽

pp. 1121-1124 ◽

Cited By ~ 46

Author(s):

RENEE D. GOODWIN

Keyword(s):

Anxiety Disorder ◽

Major Depression ◽

Anxiety Disorders ◽

Panic Attack ◽

Panic Attacks ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Sociodemographic Differences ◽

Co Morbidity

Objective. To determine the association between anxiety disorders, panic attack and the risk of major depression among adults in the community.Method. Data were drawn from the Epidemiologic Catchment Area Program survey waves 1 (N = 20291) and 2 (N = 15849). Multivariate logistic regression analyses were used to determine the risk of incident major depression at 12-month follow-up (wave 2) associated with each anxiety disorder and panic attacks assessed at wave 1, adjusting for differences in sociodemographic characteristics, and then controlling simultaneously for all anxiety disorders, and other psychiatric co-morbidity.Results. Specific phobia (OR = 1.7 (1.6, 1.8)), agoraphobia (OR = 2.3 (2.2, 2.5)), obsessive–compulsive disorder (OR = 5.4 (5.0, 5.8)) and panic attack (OR = 1.9 (1.8, 2.1)) each made an independent contribution to the risk of major depression, which persisted after adjusting simultaneously for sociodemographic differences and other psychiatric co-morbidity. Conclusions. Each anxiety disorder and panic attacks appear to confer an independent risk for the onset of major depression within 12-months among adults in the community. Understanding the key role played by anxiety in depression onset is needed for prevention strategies.

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