Abstract
Background: Approximately 86–89% of patients with BD have a comorbid anxiety disorder associated with poor quality of life and reduced likelihood of recovery from an acute mood episode. The purpose of this study is to assess the prevalence and impact of comorbid anxiety using the Bipolar Inventory of Symptoms Scale (BISS) in patients with BD who participated in a 6-month pragmatic trial. Methods: Participants (N = 482) in the Bipolar Clinical Health Outcomes Initiative in Comparative Effectiveness (CHOICE) study were adults with BD I or II. Anxiety diagnoses were assessed with the MINI. Global illness severity was assessed using the Clinical Global Impression-Bipolar Version. Mood symptoms and anxiety severity were assessed using the BISS. Results: 61% of the study sample met criteria for a current anxiety disorder. Patients with a higher BISS anxiety score at baseline had a higher overall BD illness severity, depressive severity, and manic episode severity (p < 0.001). A single cutoff value of BISS anxiety had great sensitivity, yet poor specificity for determining a comorbid anxiety diagnosis. There were no significant differences in outcomes for individuals treated for anxiety disorders with anxiolytics compared with those who were not treated with anxiolytics. Limitations: Sample size limitations prevented an analysis of whether the BISS cutoff score of 10 performed differently across varied anxiety disorders. Conclusions: Given its ability to identify patients with co-occurring anxiety, the BISS anxiety subscale shows clinical utility as a screening measure though its application as a clinical assessment measure may not be advisable.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 126-131 |
| Number of pages | 6 |
| Journal | Journal of Affective Disorders |
| Volume | 246 |
| DOIs | |
| State | Published - Mar 1 2019 |
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Keywords
- Anxiety disorders
- Bipolar disorder
- Bipolar inventory of symptoms scale
- Comparative effectiveness research
- Mood disorders
ASJC Scopus subject areas
- Clinical Psychology
- Psychiatry and Mental health
Cite this
Comorbid anxiety in bipolar CHOICE : Insights from the bipolar inventory of symptoms scale. / Kinrys, Gustavo; Bowden, Charles L.; Nierenberg, Andrew A.; Hearing, Casey M.; Gold, Alexandra K.; Rabideau, Dustin J.; Sylvia, Louisa G.; Gao, Keming; Kamali, Masoud; Bobo, William V; Tohen, Mauricio; Deckersbach, Thilo; McElroy, Susan L.; Ketter, Terence A.; Shelton, Richard C.; Friedman, Edward S.; Calabrese, Joseph R.; McInnis, Melvin G.; Kocsis, James; Thase, Michael E.; Singh, Vivek; Reilly-Harrington, Noreen A.
In: Journal of Affective Disorders, Vol. 246, 01.03.2019, p. 126-131.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Comorbid anxiety in bipolar CHOICE
T2 - Insights from the bipolar inventory of symptoms scale
AU - Kinrys, Gustavo
AU - Bowden, Charles L.
AU - Nierenberg, Andrew A.
AU - Hearing, Casey M.
AU - Gold, Alexandra K.
AU - Rabideau, Dustin J.
AU - Sylvia, Louisa G.
AU - Gao, Keming
AU - Kamali, Masoud
AU - Bobo, William V
AU - Tohen, Mauricio
AU - Deckersbach, Thilo
AU - McElroy, Susan L.
AU - Ketter, Terence A.
AU - Shelton, Richard C.
AU - Friedman, Edward S.
AU - Calabrese, Joseph R.
AU - McInnis, Melvin G.
AU - Kocsis, James
AU - Thase, Michael E.
AU - Singh, Vivek
AU - Reilly-Harrington, Noreen A.
PY - 2019/3/1
Y1 - 2019/3/1
N2 - Background: Approximately 86–89% of patients with BD have a comorbid anxiety disorder associated with poor quality of life and reduced likelihood of recovery from an acute mood episode. The purpose of this study is to assess the prevalence and impact of comorbid anxiety using the Bipolar Inventory of Symptoms Scale (BISS) in patients with BD who participated in a 6-month pragmatic trial. Methods: Participants (N = 482) in the Bipolar Clinical Health Outcomes Initiative in Comparative Effectiveness (CHOICE) study were adults with BD I or II. Anxiety diagnoses were assessed with the MINI. Global illness severity was assessed using the Clinical Global Impression-Bipolar Version. Mood symptoms and anxiety severity were assessed using the BISS. Results: 61% of the study sample met criteria for a current anxiety disorder. Patients with a higher BISS anxiety score at baseline had a higher overall BD illness severity, depressive severity, and manic episode severity (p < 0.001). A single cutoff value of BISS anxiety had great sensitivity, yet poor specificity for determining a comorbid anxiety diagnosis. There were no significant differences in outcomes for individuals treated for anxiety disorders with anxiolytics compared with those who were not treated with anxiolytics. Limitations: Sample size limitations prevented an analysis of whether the BISS cutoff score of 10 performed differently across varied anxiety disorders. Conclusions: Given its ability to identify patients with co-occurring anxiety, the BISS anxiety subscale shows clinical utility as a screening measure though its application as a clinical assessment measure may not be advisable.
AB - Background: Approximately 86–89% of patients with BD have a comorbid anxiety disorder associated with poor quality of life and reduced likelihood of recovery from an acute mood episode. The purpose of this study is to assess the prevalence and impact of comorbid anxiety using the Bipolar Inventory of Symptoms Scale (BISS) in patients with BD who participated in a 6-month pragmatic trial. Methods: Participants (N = 482) in the Bipolar Clinical Health Outcomes Initiative in Comparative Effectiveness (CHOICE) study were adults with BD I or II. Anxiety diagnoses were assessed with the MINI. Global illness severity was assessed using the Clinical Global Impression-Bipolar Version. Mood symptoms and anxiety severity were assessed using the BISS. Results: 61% of the study sample met criteria for a current anxiety disorder. Patients with a higher BISS anxiety score at baseline had a higher overall BD illness severity, depressive severity, and manic episode severity (p < 0.001). A single cutoff value of BISS anxiety had great sensitivity, yet poor specificity for determining a comorbid anxiety diagnosis. There were no significant differences in outcomes for individuals treated for anxiety disorders with anxiolytics compared with those who were not treated with anxiolytics. Limitations: Sample size limitations prevented an analysis of whether the BISS cutoff score of 10 performed differently across varied anxiety disorders. Conclusions: Given its ability to identify patients with co-occurring anxiety, the BISS anxiety subscale shows clinical utility as a screening measure though its application as a clinical assessment measure may not be advisable.
KW - Anxiety disorders
KW - Bipolar disorder
KW - Bipolar inventory of symptoms scale
KW - Comparative effectiveness research
KW - Mood disorders
UR - http://www.scopus.com/inward/record.url?scp=85058949458&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85058949458&partnerID=8YFLogxK
U2 - 10.1016/j.jad.2018.12.039
DO - 10.1016/j.jad.2018.12.039
M3 - Article
VL - 246
SP - 126
EP - 131
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
SN - 0165-0327
ER -