Comorbid Anxiety in Bipolar Disorder: Does It Have an Independent Effect on Suicidality?

Overview

Journal Bipolar Disord

Specialty Psychiatry

Date 2008 May 3

PMID 18452449

Citations 14

Authors

Atsuo Nakagawa

Michael F Grunebaum

Gregory M Sullivan

Dianne Currier

Steven P Ellis

Ainsley K Burke

David A Brent

J John Mann

Maria A Oquendo

Affiliations

Soon will be listed here.

Abstract

Objective: Comorbid anxiety disorder is reported to increase suicidality in bipolar disorder. However, studies of the impact of anxiety disorders on suicidal behavior in mood disorders have shown mixed results. The presence of personality disorders, often comorbid with anxiety and bipolar disorders, may explain these inconsistencies. This study examined the impact of comorbid Cluster B personality disorder and anxiety disorder on suicidality in bipolar disorder.

Methods: A total of 116 depressed bipolar patients with and without lifetime anxiety disorder were compared. Multiple regression analysis tested the association of comorbid anxiety disorder with past suicide attempts and severity of suicidal ideation, adjusting for the effect of Cluster B personality disorder. The specific effect of panic disorder was also explored.

Results: Bipolar patients with and without anxiety disorders did not differ in the rate of past suicide attempt. Suicidal ideation was less severe in those with anxiety disorders. In multiple regression analysis, anxiety disorder was not associated with past suicide attempts or with the severity of suicidal ideation, whereas Cluster B personality disorder was associated with both. The results were comparable when comorbid panic disorder was examined.

Conclusions: Comorbid Cluster B personality disorder appears to exert a stronger influence on suicidality than comorbid anxiety disorder in persons with bipolar disorder. Assessment of suicide risk in patients with bipolar disorder should include evaluation and treatment of Cluster B psychopathology.

Citing Articles

Comorbid Anxiety Increases Suicidal Risk in Bipolar Depression: Analysis of 9720 Adolescent Inpatients.

Amuk O, Patel R Behav Sci (Basel). 2020; 10(7).

PMID: 32635572 PMC: 7408112. DOI: 10.3390/bs10070108.

Prevalence and Associated Features of Anxiety Disorder Comorbidity in Bipolar Disorder: A Meta-Analysis and Meta-Regression Study.

Eser H, Kacar A, Kilciksiz C, Yalcinay-Inan M, Ongur D Front Psychiatry. 2018; 9:229.

PMID: 29997527 PMC: 6030835. DOI: 10.3389/fpsyt.2018.00229.

Effects of anxiety on suicidal ideation: exploratory analysis of a paroxetine versus bupropion randomized trial.

Parris M, Marver J, Chaudhury S, Ellis S, Metts A, Keilp J Int Clin Psychopharmacol. 2018; 33(5):249-254.

PMID: 29864037 PMC: 6066420. DOI: 10.1097/YIC.0000000000000225.

Are comorbid anxiety disorders a risk factor for suicide attempts in patients with mood disorders? A two-year prospective study.

Abreu L, Oquendo M, Galfavy H, Burke A, Grunebaum M, Sher L Eur Psychiatry. 2017; 47:19-24.

PMID: 29096128 PMC: 5766396. DOI: 10.1016/j.eurpsy.2017.09.005.

Prevalence, impact and treatment of generalised anxiety disorder in bipolar disorder: a systematic review and meta-analysis.

Preti A, Vrublevska J, Veroniki A, Huedo-Medina T, Fountoulakis K Evid Based Ment Health. 2016; 19(3):73-81.

PMID: 27405742 PMC: 10699460. DOI: 10.1136/eb-2016-102412.

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