Tonguç Demir BERKOL
(Bakırköy Araştırma ve Psikiyatri Nöroloji ve Nöroşirürji Eğitim Hastanesi, Psikiyatri Anabilim Dalı, İstanbul, Türkiye)
Hasan Mervan AYTAÇ
(Başakşehir Çam ve Sakura Şehir Hastanesi, Psikiyatri Anabilim Dalı, İstanbul, Türkiye)
Yıl: 2021Cilt: 53Sayı: 3ISSN: 1308-8734 / 1308-8742Sayfa Aralığı: 203 - 207İngilizce

2 0
Comparison of Clinical Features of Bipolar Disorder Patients with and without Psychiatric Comorbidity
Objective: Bipolar disorder (BPD) is a psychiatric condition that often manifests together with Axis-I comorbidity. Comorbidity of psychiatric disorders influences the recognition, prognosis, and treatment of the disorder, posing difficulties for the patient and physician. This study aims at identifying Axis-I comorbidities and their characteristics in patients with BPD. Materials and Methods: This retrospective study included 255 patients diagnosed with BPD according to the DSM-IV. Comorbidities were determined using the SCID-I, a semistructured sociodemographic data form developed by the authors, and a mood chart assessing clinical aspects. The patients were divided into 2 groups, those with and without comorbidity, and compared. Results: Out of these 255 patients, 35% was found to have a current and 84.3% a lifelong comorbid psychiatric disorder. About 33.1% of these patients had 1, 11.3% had 2, and 8.8% had more than 2 comorbid disorders. At least one comorbid anxiety disorder was found in 38.7% of the patients. Obsessive and compulsive disorder (OCD) being the most common comorbid psychiatric disorder, followed by social anxiety disorder (SAD), posttraumatic stress disorder (PTSD), and generalized anxiety disorder (GAD). Comparing the clinical parameters between the 2 groups due to the presence of psychiatric comorbidity in the BD patients, there were statistically significant differences in terms of the number of depressive episodes (P = .041) and mania/hypomania (P = .048), and the need for antipsychotic monotherapy (P = .007) and antidepressants (P = .001) for prophylaxis between the 2 groups. Conclusion: Axis-I psychiatric disorders and particularly OCD and anxiety disorders accompanying BPD prevail at a high rate. The presence of comorbid psychiatric disorder in BPD may negatively affect the clinical prognosis of the condition; therefore, this area requires more study and careful investigation.
DergiAraştırma MakalesiErişime Açık
  • 1. Asaad T, Okasha T, Ramy H, et al. Correlates of psychiatric co-morbidity in a sample of Egyptian patients with bipolar disorder. J Affect Disord. 2014;166:347-352. [Crossref]
  • 2. Sadock B, Sadock V, Ruiz P, Kaplan HI. Synopsis of Psychiatry: Behavioral Sciences/clinical Psychiatry. 11th ed. Philadelphia: Copyright Â; 2014.
  • 3. Fellinger M, Waldhor T, Bluml V, Williams N, Vyssoki B. Influence of gender on inpatient treatment for bipolar disorder: An analysis of 60,607 hospitalisations. J Affect Disord. 2018;225:104-107. [Crossref]
  • 4. Buoli M, Cesana BM, Dell’Osso B, et al. Genderrelated differences in patients with bipolar disorder: A nationwide study. CNS Spectr. 2019;24 (6):589-596. [Crossref]
  • 5. Berkol TD, Aytaç HM, Serkan I, Yumrukçal H, Ozgen G, Ozyıldırım I. Differences in men and women with bipolar-I diagnosed patients. JNBS. 2017;4(2):72-76. [Crossref]
  • 6. Preti A, Vrublevska J, Veroniki AA, Huedo-Medina TB, Kyriazis O, Fountoulakis KN. Prevalence and treatment of panic disorder in bipolar disorder: Systematic review and meta-analysis. Evid Based Ment Health. 2018;21(2):53-60. [Crossref]
  • 7. Saraf G, Paul I, Viswanath B, Narayanaswamy JC, Math SB, Reddy YC. Bipolar disorder comorbidity in patients with a primary diagnosis of OCD. Int J Psychiatry Clin Pract. 2017;21(1):70-74. [Crossref]
  • 8. Masi G, Berloffa S, Mucci M, et al. A naturalistic exploratory study of Obsessive-compulsive bipolar comorbidity in youth. J Affect Disord. 2018;231:21-26. [Crossref]
  • 9. Goes FS. The importance of anxiety states in bipolar disorder. Curr Psychiatry Rep. 2015;17 (2):3. [Crossref]
  • 10. Nabavi B, Mitchell AJ, Nutt D, Lifetime A. A lifetime prevalence of comorbidity between bipolar affective disorder and anxiety disorders: A meta-analysis of 52 interview-based studies of psychiatric population. E Bio Medicine. 2015;2 (10):1405-1419. [Crossref]
  • 11. Pavlova B, Perlis RH, Alda M, Uher R. Lifetime prevalence of anxiety disorders in people with bipolar disorder: A systematic review and meta-analysis. Lancet Psychiatry. 2015;2(8):710- 717. [Crossref]
  • 12. Kinrys G, Bowden CL, Nierenberg AA, et al. Comorbid anxiety in bipolar CHOICE: Insights from the bipolar inventory of symptoms scale. J Affect Disord. 2019;246:126-131. [Crossref]
  • 13. Titone MK, Freed RD, O’Garro-Moore JK, et al. The role of lifetime anxiety history in the course of bipolar spectrum disorders. Psychiatry Res. 2018;264:202-209. [Crossref]
  • 14. Berutti M, Nery FG, Sato R, Scippa A, Kapczinski F, Lafer B. Association between family history of mood disorders and clinical characteristics of bipolar disorder: Results from the Brazilian bipolar research network. J Affect Disord. 2014;161:104- 108. [Crossref]
  • 15. Schaffer A, Isometsa ET, Tondo L, et al. International society for bipolar disorders task force on suicide: Meta-analyses and meta-regression of correlates of suicide attempts and suicide deaths in bipolar disorder. Bipolar Disord. 2015;17(1):1-16. [Crossref]
  • 16. Berkol TD, Islam S, Kirli E, Pinarbasi R, Ozyildirim İ. Suicide attempts and clinical features of bipolar patients. Saudi Med J. 2016;37(6):662-667. [Crossref]
  • 17. First MB, Spitzer RL, Gibbon M, Williams JB. User’s Guide for the Structured Clinical Interview for DSM-IV Axis I Disorders SCID-I: Clinician version. American Psychiatric Press; Biometrics Research Department, New York State Psychiatric Institute, New York: 1997.
  • 18. Çorapçıoğlu A, Aydemir Ö, Yıldız M, Esen A, Köroğlu E. DSM-IV Eksen I Bozuklukları (SCID-I) Için Yapılandırılmış Klinik Görüşme, Klinik Versiyon. Ankara: Hekimler yayın birliği; 1999.
  • 19. Vieta E, Nieto E, Autet A, et al. A long-term prospective study on the outcome of bipolar patients treated with long-acting injectable risperidone. World J Biol Psychiatry. 2008;9 (3):219-224. [Crossref]
  • 20. Spoorthy MS, Chakrabarti S, Grover S. Comorbidity of bipolar and anxiety disorders: An overview of trends in research. World J Psychiatry. 2019;9(1):7-29. [Crossref]
  • 21. Kim SW, Berk L, Kulkarni J, et al. Impact of comorbid anxiety disorders and obsessive–compulsive disorder on 24-month clinical outcomes of bipolar I disorder. J Affect Disord. 2014;166:243-248. [Crossref]
  • 22. Altindag A, Yanik M, Nebioglu M. The comorbidity of anxiety disorders in bipolar I patients: Prevalence and clinical correlates. Isr J Psychiatry Relat Sci. 2006;43(1):10-15.
  • 23. Amerio A. Suicide risk in comorbid bipolar disorder and obsessive-compulsive disorder: A systematic review. Indian J Psychol Med. 2019;41(2):133. [Crossref]
  • 24. Amerio A, Odone A, Liapis CC, Ghaemi SN. Diagnostic validity of comorbid bipolar disorder and obsessive-compulsive disorder: A systematic review. Acta Psychiatr Scand. 2014;129(5):343- 358. [Crossref]
  • 25. Raouna A, Osam CS, MacBeth A. Clinical staging model in offspring of parents with bipolar disorder: A systematic review. Bipolar Disord. 2018;20(4):313-333. [Crossref]
  • 26. Carlson GA, Pataki C. Understanding early age of onset: A review of the last 5 years. Curr Psychiatry Rep. 2016;18(12):114. [Crossref]
  • 27. Henry C, Van Den Bulke D, Bellivier F, Etain B, Rouillon F, Leboyer M. Anxiety disorders in 318 bipolar patients: Prevalence and impact on illness severity and response to mood stabilizer. J Clin Psychiatry. 2003;64(3):331-335. [Crossref]
  • 28. Kim H, Kim W, Citrome L, et al. More inclusive bipolar mixed depression definition by permitting overlapping and non-overlapping mood elevation symptoms. Acta Psychiatr Scand. 2016;134(3):199- 206. [Crossref]
  • 29. Berkol TD, Kirli E, Islam S, Pinarbasi R, Ozyildirim İ. Comparison of clinical and sociodemographic features of bipolar disorder patients with those of social anxiety disorder patients comorbid with bipolar disorder in Turkey. Saudi Med J. 2016;37 (3):309-314. [Crossref]
  • 30. Del Grande C, Muti M, Musetti L, et al. Lithium and valproate in manic and mixed states: A naturalistic prospective study. J Psychopathol. 2014;20(610):29.
  • 31. Hocaoğlu Ç, Aytaç HM. Özel Grup ve Kurum İntiharları (Cezaevi, Asker, Polis). Turkiye Klinikleri Psychiatry-Special Topics. 2016;9(3):37-50.

TÜBİTAK ULAKBİM Ulusal Akademik Ağ ve Bilgi Merkezi Cahit Arf Bilgi Merkezi © 2019 Tüm Hakları Saklıdır.