Anxiety comorbidity and quality of life in bipolar disorder patients

Department of Biochemistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Canadian journal of psychiatry. Revue canadienne de psychiatrie (Impact Factor: 2.55). 04/2007; 52(3):175-81.
Source: PubMed


To assess the impact of anxiety comorbidity on the quality of life of patients with bipolar disorder (BD).
We undertook a cross-Sectional survey of 162 BD outpatients interviewed with the Structured Clinical Interview for DSM-IV. The primary outcome measure was quality of life, assessed with the 26-item WHO Quality of Life Instrument (WHOQOL-BREF).
Anxiety comorbidity in BD patients was associated with lower scores in all domains of quality of life. The impact of anxiety comorbidity on the psychological domain of the WHOQOL-BREF was kept, even when the current level of depression was added to the model as a confounding factor. Current anxiety comorbidity was also associated with lifetime alcohol abuse and dependence, rapid cycling, lifetime psychosis, number of suicide attempts, and a lower score in the Global Assessment of Functioning measure.
Our findings suggest that anxiety comorbidity in BD patients is related to lower quality of life, particularly on the psychological domain. BD-anxiety comorbidity may be associated with such markers of illness severity as number of suicide attempts, rapid cycling, lifetime alcohol abuse, and psychosis. The recognition and treatment of anxiety comorbidity may help patients with BD to relieve their psychological pain and improve their overall quality of life.

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Available from: Keila Ceresér, May 11, 2014
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    • "In addition, BD patients often experience anxiety, which is associated to suicide attempts, lifetime alcohol abuse, and psychosis [6]. Depression is characterized by sadness and hopelessness (including suicidal ideation), whereas mania leads to euphoria or irritability, excessive energy, hyperactivity, hypertrophic self-esteem, and a reduction of the need of sleep. "
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    ABSTRACT: This study discusses a personalized wearable monitoring system which provides information and communication technologies to patients with mental disorders and physicians managing such diseases. The system, hereinafter called the PSYCHE system, is mainly comprised of a comfortable t-shirt with embedded sensors, such as textile electrodes, to monitor electrocardiogram-Heart Rate Variability (HRV) series, piezoresistive sensors for respiration activity, and tri-axial accelerometers for activity recognition. Moreover, on the patient-side, PSYCHE system uses a smartphone-based interactive platform for electronic mood agenda and clinical scale administration, whereas on the physician-side provides data visualization and support to clinical decision. The smartphone collects the physiological and behavioral data and sends the information out to a centralized server for further processing. In this study, we present experimental results gathered from ten bipolar patients, wearing the PSYCHE system, with severe symptoms who exhibited mood states among depression (DP), hypomania(HM), mixed state (MX), and euthymia (EU), i.e., the good affective balance. In analyzing more than 400 hours of cardiovascular dynamics, we found that patients experiencing mood transitions from a pathological mood state (HM, DP or MX - where depressive and hypomanic symptoms are simultaneously present) to EU can be characterized through a commonly used measure of entropy. In particular, the SampEn estimated on long term HRV series increases according to the patients' clinical improvement. These results are in agreement with the current literature reporting on the complexity dynamics of physiological systems and provides a promising and viable support to clinical decisionin order to improve the diagnosis and management of psychiatric disorders.
    Full-text · Article · Sep 2014 · IEEE Journal of Biomedical and Health Informatics
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    • "Although we did not examine comorbidity with anxiety disorders but the negative association of psychic anxiety with QOL may be interpreted in line with previous reports indicating a detrimental effect of such comorbidity on QOL [40–42]. Comorbidity of BD and anxiety may be associated with markers of illness severity such as number of suicide attempts [43]. The nature of this negative association needs to be explored in the future studies. "
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    ABSTRACT: Objectives . The aims of this study were (i) to compare Quality of Life (QOL) of patients with bipolar disorder (BD) type I to those with schizophrenia during a one-year period after hospitalization and (ii) to assess the association of different domains of QOL with severity of clinical symptoms and level of functioning in bipolar patients group. Method . A hundred and two participants were consecutively recruited before discharge from an acute hospitalization. To measure QOL as the main outcome variable, the Farsi (Persian) version of the World Health Organization's QOL Instrument Short Version (WHOQOL BREF) was used. Affective symptoms, overall functioning, and severity of mental illness were assessed as well. The assessment procedure was repeated four, eight, and 12 months after discharge. Results . No significant differences were found between patients with BD and schizophrenia on four domains of WHOQOL BREF at the baseline and the four, eight, and 12 month assessments. Within the subjects with bipolar I disorder, the most stable finding was negative association of depression severity with WHOQOL-BREF on the all four domains during repeated assessments. Conclusion . The findings suggest that persistent depressive symptoms might be the primary determinant of impaired QOL in patients with bipolar I disorder.
    Full-text · Article · Dec 2012 · Depression research and treatment
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    • "Many patients with bipolar disorder also meet the DSM-IV criteria for an anxiety disorder [7] [8], with a lifetime prevalence for any anxiety disorder of about 50% [9] [10]. The potential consequences of a co-occurring anxiety disorder include an increased risk of suicidal ideation and behaviors [11] [12], recurrent subsyndromal symptoms [13], greater time spent ill [14] [15], an inadequate response to mood stabilizers [11,16Á18], poor overall outcome [14,15,19Á21], and a lower quality of life [22]. Patients with bipolar disorder are commonly prescribed adjunctive anxiolytic medications , including those without a comorbid diagnosis of an anxiety disorder. "
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    ABSTRACT: Objective. Many patients with bipolar disorder take adjunctive medications for anxiety. Using naturalistic data, we investigated the relationship between the use of adjunctive anxiolytics and the time spent in episodes or with subsyndromal mood symptoms. Methods. This was a post-hoc analysis of 310 patients with bipolar disorder who previously recorded mood and medications daily for 5 months using ChronoRecord software. One hundred patients were taking adjunctive anxiolytics for at least 50% of days; 210 were not. Of the 100 patients, 73 were taking a benzodiazepine. All patients taking anxiolytics were also receiving treatments for bipolar disorder. Results. Patients with bipolar disorder who were taking adjunctive medications for anxiety spent more time ill. Comparing patients who were taking or not taking anxiolytics, the mean days spent either in any episode or with subsyndromal symptoms was 45.6 vs. 29.6%, respectively (P
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