Yapici Eser Hale, Kacar Anil S, Kilciksiz Can M, Yalçinay-Inan Merve, Ongur Dost
School of Medicine, Koç University, Sariyer, Turkey.
Research Center for Translational Medicine, Koç University, Istanbul, Turkey.
Front Psychiatry. 2018 Jun 27;9:229. doi: 10.3389/fpsyt.2018.00229. eCollection 2018.
Bipolar disorder is highly comorbid with anxiety disorders, however current and lifetime comorbidity patterns of each anxiety disorder and their associated features are not well studied. Here, we aimed to conduct a meta-analysis and meta-regression study of current evidence. We searched PubMed to access relevant articles published until September 2015, using the keywords "Bipolar disorder" or "Affective Psychosis" or "manic depressive" separately with "generalized anxiety," "panic disorder," "social phobia," "obsessive compulsive," and "anxiety." Variables for associated features and prevalence of anxiety disorders were carefully extracted. Lifetime any anxiety disorder comorbidity in BD was 40.5%; panic disorder (PD) 18.1%, generalized anxiety disorder (GAD) 13.3%, social anxiety disorder (SAD) 13.5% and obsessive compulsive disorder (OCD) 9.7%. Current any anxiety disorder comorbidity in BD is 38.2%; GAD is 15.2%, PD 13.3%, SAD 11.7%, and OCD 9.9%. When studies reporting data about comorbidities in BDI or BDII were analyzed separately, lifetime any anxiety disorder comorbidity in BDI and BDII were 38% and 34%, PD was 15% and 15%, GAD was 14% and 16.6%, SAD was 8% and 13%, OCD was 8% and 10%, respectively. Current any DSM anxiety disorder comorbidity in BDI or BDII were 31% and 37%, PD was 9% and 13%, GAD was 8% and 12%, SAD was 7% and 11%, and OCD was 8% and 7%, respectively. The percentage of manic patients and age of onset of BD tended to have a significant impact on anxiety disorders. Percentage of BD I patients significantly decreased the prevalence of panic disorder and social anxiety disorder. A higher rate of substance use disorder was associated with greater BD-SAD comorbidity. History of psychotic features significantly affected current PD and GAD. Anxiety disorder comorbidity is high in BD with somewhat lower rates in BDI vs BDII. Age of onset, substance use disorders, and percentage of patients in a manic episode or with psychotic features influences anxiety disorder comorbidity.
双相情感障碍与焦虑症高度共病，然而每种焦虑症的当前及终生共病模式及其相关特征尚未得到充分研究。在此，我们旨在对现有证据进行荟萃分析和荟萃回归研究。我们检索了PubMed以获取截至2015年9月发表的相关文章，分别使用关键词“双相情感障碍”或“情感性精神病”或“躁狂抑郁症”与“广泛性焦虑”、“惊恐障碍”、“社交恐惧症”、“强迫症”和“焦虑”。仔细提取了焦虑症相关特征和患病率的变量。双相情感障碍患者终生任何焦虑症共病率为40.5%；惊恐障碍（PD）为18.1%，广泛性焦虑症（GAD）为13.3%，社交焦虑症（SAD）为13.5%，强迫症（OCD）为9.7%。双相情感障碍患者当前任何焦虑症共病率为38.2%；广泛性焦虑症为15.2%，惊恐障碍为13.3%，社交焦虑症为11.7%，强迫症为9.9%。当分别分析报告双相情感障碍I型（BDI）或双相情感障碍II型（BDII）共病数据的研究时，BDI和BDII终生任何焦虑症共病率分别为38%和34%，惊恐障碍分别为15%和15%，广泛性焦虑症分别为14%和16.6%，社交焦虑症分别为8%和13%，强迫症分别为8%和10%。BDI或BDII当前任何DSM焦虑症共病率分别为31%和37%，惊恐障碍分别为9%和13%，广泛性焦虑症分别为8%和12%，社交焦虑症分别为7%和11%，强迫症分别为8%和7%。双相情感障碍患者中躁狂患者的比例和发病年龄往往对焦虑症有显著影响。BDI患者的比例显著降低了惊恐障碍和社交焦虑症的患病率。物质使用障碍的较高发生率与双相情感障碍-社交焦虑症的更高共病率相关。精神病性特征史显著影响当前的惊恐障碍和广泛性焦虑症。双相情感障碍中焦虑症共病率较高，BDI的共病率略低于BDII。发病年龄、物质使用障碍以及躁狂发作或有精神病性特征的患者比例会影响焦虑症共病。
