Comorbid anxiety in bipolar CHOICE

Insights from the bipolar inventory of symptoms scale

Gustavo Kinrys, Charles L. Bowden, Andrew A. Nierenberg, Casey M. Hearing, Alexandra K. Gold, Dustin J. Rabideau, Louisa G. Sylvia, Keming Gao, Masoud Kamali, William V Bobo, Mauricio Tohen, Thilo Deckersbach, Susan L. McElroy, Terence A. Ketter, Richard C. Shelton, Edward S. Friedman, Joseph R. Calabrese, Melvin G. McInnis, James Kocsis, Michael E. Thase & 2 others Vivek Singh, Noreen A. Reilly-Harrington

Research output: Contribution to journalArticle

2 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)126-131
Number of pages6
JournalJournal of Affective Disorders
Volume246
DOIs
StatePublished - Mar 1 2019

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Anxiety
Equipment and Supplies
Health
Anxiety Disorders
Anti-Anxiety Agents
Pragmatic Clinical Trials
Aptitude
Sample Size
Quality of Life

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

Kinrys, G., Bowden, C. L., Nierenberg, A. A., Hearing, C. M., Gold, A. K., Rabideau, D. J., ... Reilly-Harrington, N. A. (2019). Comorbid anxiety in bipolar CHOICE: Insights from the bipolar inventory of symptoms scale. Journal of Affective Disorders, 246, 126-131. https://doi.org/10.1016/j.jad.2018.12.039

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 journalArticle

Kinrys, G, Bowden, CL, Nierenberg, AA, Hearing, CM, Gold, AK, Rabideau, DJ, Sylvia, LG, Gao, K, Kamali, M, Bobo, WV, Tohen, M, Deckersbach, T, McElroy, SL, Ketter, TA, Shelton, RC, Friedman, ES, Calabrese, JR, McInnis, MG, Kocsis, J, Thase, ME, Singh, V & Reilly-Harrington, NA 2019, 'Comorbid anxiety in bipolar CHOICE: Insights from the bipolar inventory of symptoms scale', Journal of Affective Disorders, vol. 246, pp. 126-131. https://doi.org/10.1016/j.jad.2018.12.039
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. / Comorbid anxiety in bipolar CHOICE : Insights from the bipolar inventory of symptoms scale. In: Journal of Affective Disorders. 2019 ; Vol. 246. pp. 126-131.
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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.",
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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.

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