Risk factors for an anxiety disorder comorbidity among Thai patients with bipolar disorder: results from the Thai Bipolar Disorder Registry

SummaryWe offer a contemporary review of studies of the offspring of parents with bipolar disorder and explore the clinical characteristics of these populations. We discuss how different methodological approaches may influence study findings and may explain some of the heterogeneity in the results reported. We also highlight some of the environmental risk factors that may increase the likelihood of transition from an ‘at-risk’ or high-risk state to bipolar disorder. Last, we briefly discuss the implications of study findings for early intervention strategies and comment on such issues as genetic counselling and primary and early secondary prevention programmes.

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The Prevalence of Comorbid Anxiety in Schizophrenia, Schizoaffective Disorder and Bipolar Disorder

Australian & New Zealand Journal of Psychiatry ◽

10.3109/00048679809062708 ◽

1998 ◽

Vol 32 (1) ◽

pp. 67-72 ◽

Cited By ~ 132

Author(s):

Susan J. Cosoff ◽

R. Julian Hafner

Keyword(s):

Bipolar Disorder ◽

Anxiety Disorder ◽

Anxiety Disorders ◽

Schizoaffective Disorder ◽

Psychiatric Symptoms ◽

Psychotic Episode ◽

Obsessive Compulsive ◽

General Anxiety ◽

Admission Rates ◽

Clinical Benefits

Objective: The aim of this study to determine the prevalence of anxiety disorders in publically treated psychiatric inpatients with a DSM-IV diagnosis of schizophrenia, schizoaffective disorder or bipolar disorder. Method: Using the Structured Clinical Interview for DSM-III-R (SCID), 100 consecutive inpatients with a psychotic disorder were examined for the presence or absence of an anxiety disorder. Questionnaire measures of phobias, obsessive-compulsive and general anxiety symptoms were also applied. Results: The prevalences of social phobia (17%), obsessiv-ompulsive disorder (13%) and generalised anxiety disorder in schizophrenia were relatively high, as were prevalences of obsessive-compulsive (30%) and panic disorder (15%) in bipolar disorder. The proportion of subjects with an anxiety disorder (4345%) was almost identical across the three psychoses, with some evidence of gender differences. Although self-ratings of overall psychiatric symptoms were significantly elevated in those with anxiety disorders, hospital admission rates were not. Conclusions: Almost none of those with anxíeGty disorders were being treated for them, primarily because the severity of the acute psychotic illness required full diagnostic and therapeutic attention. Patients were generally discharged as soon as their psychotic episode was resolved, with little recognition of the presence of an anxiety disorder. Given that anxiety disorders are relatively responsive to treatment, greater awareness of their comorbidity with psychosis should yield worthwhile clinical benefits.

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Major Depression and Generalised Anxiety Disorder

The British Journal of Psychiatry ◽

10.1192/s0007125000298437 ◽

1996 ◽

Vol 168 (S30) ◽

pp. 68-75 ◽

Cited By ~ 204

Author(s):

Kenneth S. Kendler

Keyword(s):

Risk Factors ◽

Anxiety Disorder ◽

Major Depression ◽

Environmental Risk ◽

Genetic Factors ◽

Environmental Risk Factors ◽

Generalised Anxiety Disorder ◽

Increase Risk ◽

Twin Models ◽

One Year

In both clinical and epidemiological samples, major depression (MD) and generalised anxiety disorder (GAD) display substantial comorbidity. In a prior analysis of lifetime MD and GAD in female twins, the same genetic factors were shown to influence the liability to MD and to GAD. A follow-up interview in the same twin cohort examined one-year prevalence for MD and GAD (diagnosed using a one-month minimum duration of illness). Bivariate twin models were fitted using the program Mx. High levels of comorbidity were observed between MD and GAD. The best-fitting twin models, when GAD was diagnosed with or without a diagnostic hierarchy, found a genetic correlation of unity between the two disorders. The correlation in environmental risk factors was +0.70 when GAD was diagnosed non-hierarchically, but zero when hierarchical diagnoses were used. Our findings provide further support for the hypothesis that in women, MD and GAD are the result of the same genetic factors. Environmental risk factors that predispose to ‘pure’ GAD episodes may be relatively distinct from those that increase risk for MD.

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An Underlying Common Factor, Influenced by Genetics and Unique Environment, Explains the Covariation Between Major Depressive Disorder, Generalized Anxiety Disorder, and Burnout: A Swedish Twin Study

Twin Research and Human Genetics ◽

10.1017/thg.2016.73 ◽

2016 ◽

Vol 19 (6) ◽

pp. 619-627 ◽

Cited By ~ 9

Author(s):

Lisa Mather ◽

Victoria Blom ◽

Gunnar Bergström ◽

Pia Svedberg

Keyword(s):

Risk Factors ◽

Major Depressive Disorder ◽

Anxiety Disorder ◽

Environmental Factors ◽

Depressive Disorder ◽

Generalized Anxiety Disorder ◽

Common Factor ◽

Generalized Anxiety ◽

Major Depressive ◽

Common Pathway

Depression and anxiety are highly comorbid due to shared genetic risk factors, but less is known about whether burnout shares these risk factors. We aimed to examine whether the covariation between major depressive disorder (MDD), generalized anxiety disorder (GAD), and burnout is explained by common genetic and/or environmental factors. This cross-sectional study included 25,378 Swedish twins responding to a survey in 2005–2006. Structural equation models were used to analyze whether the trait variances and covariances were due to additive genetics, non-additive genetics, shared environment, and unique environment. Univariate analyses tested sex limitation models and multivariate analysis tested Cholesky, independent pathway, and common pathway models. The phenotypic correlations were 0.71 (0.69–0.74) between MDD and GAD, 0.58 (0.56–0.60) between MDD and burnout, and 0.53 (0.50–0.56) between GAD and burnout. Heritabilities were 45% for MDD, 49% for GAD, and 38% for burnout; no statistically significant sex differences were found. A common pathway model was chosen as the final model. The common factor was influenced by genetics (58%) and unique environment (42%), and explained 77% of the variation in MDD, 69% in GAD, and 44% in burnout. GAD and burnout had additive genetic factors unique to the phenotypes (11% each), while MDD did not. Unique environment explained 23% of the variability in MDD, 20% in GAD, and 45% in burnout. In conclusion, the covariation was explained by an underlying common factor, largely influenced by genetics. Burnout was to a large degree influenced by unique environmental factors not shared with MDD and GAD.

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Comparative efficacy and safety of different drugs for bipolar disorder complicated with anxiety disorder

Medicine ◽

10.1097/md.0000000000022280 ◽

2020 ◽

Vol 99 (38) ◽

pp. e22280

Author(s):

Li Yang ◽

Meili Yan ◽

Li Du ◽

Shasha Hu ◽

Zhigang Zhang

Keyword(s):

Bipolar Disorder ◽

Anxiety Disorder ◽

Efficacy And Safety ◽

Comparative Efficacy

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Risk factors for suicide in bipolar disorder: a cohort study of 12,850 patients

10.26226/morressier.5b681763b56e9b005965c0dd ◽

2018 ◽

Author(s):

Caroline Hansson

Keyword(s):

Risk Factors ◽

Bipolar Disorder ◽

Cohort Study ◽

Risk Factors For Suicide

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Personalized Models of Internalizing Symptoms for Women with Social Anxiety Disorder and Depression

10.31234/osf.io/yjq65 ◽

2020 ◽

Author(s):

Marilyn Piccirillo ◽

Thomas Rodebaugh

Keyword(s):

Risk Factors ◽

Anxiety Disorder ◽

Social Anxiety ◽

Social Anxiety Disorder ◽

Internalizing Symptoms ◽

Emotional Experience ◽

Group Level ◽

Major Depressive ◽

Individual Level ◽

Depressive Episodes

Social anxiety disorder (SAD) constitutes an important risk factor for major depressive disorder (MDD) and women are at greater risk for both disorders and their comorbidity. Despite much research examining risk factors for MDD specifically, there is limited research evaluating how individuals with SAD transition into depressive episodes. Clinical and theoretical evidence suggests that each individual may exhibit a unique personalized pattern of risk factors. These idiographic patterns may contradict group-level findings. In this study, women (N = 35) with SAD and a current or past major depressive episode completed ecological sampling of their mood and emotional experience five times a day for a month via a smartphone application. These data were analyzed using idiographic analyses to construct individual-level models of each woman’s mood. A multilevel model was constructed to determine risk factors for group-level intra-daily sadness (i.e., depressed mood). Some group-level relationships were consistent with previous research; however, most women’s models demonstrated few, and differing, risk factors for intra-daily sadness. We also examined the spread of individual-level estimates taken from group and idiographic models to determine the extent to which multilevel models can estimate individual-level effects. Implications for integrating results from idiographic methodology into existing theoretical models of psychopathology and clinical practice are discussed.

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