Axis I psychiatric comorbidity and its relationship to historical illness variables in 288 patients with bipolar disorder

S. L. McElroy, L. L. Altshuler, T. Suppes, Jr Keck P.E., Mark A Frye, K. D. Denicoff, W. A. Nolen, R. W. Kupka, G. S. Leverich, J. R. Rochussen, A. J. Rush, R. M. Post

Research output: Contribution to journalArticle

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Abstract

Objective: Bipolar disorder often co-occurs with other axis I disorders, but little is known about the relationships between the clinical features of bipolar illness and these comorbid conditions. Therefore, the authors assessed comorbid lifetime and current axis I disorders in 288 patients with bipolar disorder and the relationships of these comorbid disorders to selected demographic and historical illness variables. Method: They evaluated 288 outpatients with bipolar I or II disorder, using structured diagnostic interviews and clinician-administered and self-rated questionnaires to determine the diagnosis of bipolar disorder, comorbid axis I disorder diagnoses, and demographic and historical illness characteristics. Results: One hundred eighty-seven (65%) of the patients with bipolar disorder also met DSM-IV criteria for at least one comorbid lifetime axis I disorder. More patients had comorbid anxiety disorders (N=78, 42%) and substance use disorders (N=78, 42%) than had eating disorders (N=9, 5%). There were no differences in comorbidity between patients with bipolar I and bipolar II disorder. Both lifetime axis I comorbidity and current axis I comorbidity were associated with earlier age at onset of affective symptoms and syndromal bipolar disorder. Current axis I comorbidity was associated with a history of development of both cycle acceleration and more severe episodes over time. Conclusions: Patients with bipolar disorder often have comorbid anxiety, substance use, and, to a lesser extent, eating disorders. Moreover, axis I comorbidity, especially current comorbidity, may be associated with an earlier age at onset and worsening course of bipolar illness. Further research into the prognostic and treatment response implications of axis I comorbidity in bipolar disorder is important and is in progress.

Original languageEnglish (US)
Pages (from-to)420-426
Number of pages7
JournalAmerican Journal of Psychiatry
Volume158
Issue number3
DOIs
StatePublished - 2001
Externally publishedYes

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Bipolar Disorder
Psychiatry
Comorbidity
Age of Onset
Demography
Affective Symptoms
Anxiety Disorders
Diagnostic and Statistical Manual of Mental Disorders
Substance-Related Disorders
Outpatients
Anxiety
Interviews
Research

ASJC Scopus subject areas

  • Psychiatry and Mental health

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Axis I psychiatric comorbidity and its relationship to historical illness variables in 288 patients with bipolar disorder. / McElroy, S. L.; Altshuler, L. L.; Suppes, T.; Keck P.E., Jr; Frye, Mark A; Denicoff, K. D.; Nolen, W. A.; Kupka, R. W.; Leverich, G. S.; Rochussen, J. R.; Rush, A. J.; Post, R. M.

In: American Journal of Psychiatry, Vol. 158, No. 3, 2001, p. 420-426.

Research output: Contribution to journalArticle

McElroy, SL, Altshuler, LL, Suppes, T, Keck P.E., J, Frye, MA, Denicoff, KD, Nolen, WA, Kupka, RW, Leverich, GS, Rochussen, JR, Rush, AJ & Post, RM 2001, 'Axis I psychiatric comorbidity and its relationship to historical illness variables in 288 patients with bipolar disorder', American Journal of Psychiatry, vol. 158, no. 3, pp. 420-426. https://doi.org/10.1176/appi.ajp.158.3.420
McElroy, S. L. ; Altshuler, L. L. ; Suppes, T. ; Keck P.E., Jr ; Frye, Mark A ; Denicoff, K. D. ; Nolen, W. A. ; Kupka, R. W. ; Leverich, G. S. ; Rochussen, J. R. ; Rush, A. J. ; Post, R. M. / Axis I psychiatric comorbidity and its relationship to historical illness variables in 288 patients with bipolar disorder. In: American Journal of Psychiatry. 2001 ; Vol. 158, No. 3. pp. 420-426.
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abstract = "Objective: Bipolar disorder often co-occurs with other axis I disorders, but little is known about the relationships between the clinical features of bipolar illness and these comorbid conditions. Therefore, the authors assessed comorbid lifetime and current axis I disorders in 288 patients with bipolar disorder and the relationships of these comorbid disorders to selected demographic and historical illness variables. Method: They evaluated 288 outpatients with bipolar I or II disorder, using structured diagnostic interviews and clinician-administered and self-rated questionnaires to determine the diagnosis of bipolar disorder, comorbid axis I disorder diagnoses, and demographic and historical illness characteristics. Results: One hundred eighty-seven (65{\%}) of the patients with bipolar disorder also met DSM-IV criteria for at least one comorbid lifetime axis I disorder. More patients had comorbid anxiety disorders (N=78, 42{\%}) and substance use disorders (N=78, 42{\%}) than had eating disorders (N=9, 5{\%}). There were no differences in comorbidity between patients with bipolar I and bipolar II disorder. Both lifetime axis I comorbidity and current axis I comorbidity were associated with earlier age at onset of affective symptoms and syndromal bipolar disorder. Current axis I comorbidity was associated with a history of development of both cycle acceleration and more severe episodes over time. Conclusions: Patients with bipolar disorder often have comorbid anxiety, substance use, and, to a lesser extent, eating disorders. Moreover, axis I comorbidity, especially current comorbidity, may be associated with an earlier age at onset and worsening course of bipolar illness. Further research into the prognostic and treatment response implications of axis I comorbidity in bipolar disorder is important and is in progress.",
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AU - Altshuler, L. L.

AU - Suppes, T.

AU - Keck P.E., Jr

AU - Frye, Mark A

AU - Denicoff, K. D.

AU - Nolen, W. A.

AU - Kupka, R. W.

AU - Leverich, G. S.

AU - Rochussen, J. R.

AU - Rush, A. J.

AU - Post, R. M.

PY - 2001

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