Wang Yuting, Liu Jiao, Zhang Ran, Luo Guoshuai, Sun Daliang
The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders and Department of Psychiatry, Capital Medical University and Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China.
Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin, 300222, China.
J Neural Transm (Vienna). 2025 Apr;132(4):567-578. doi: 10.1007/s00702-024-02876-x. Epub 2025 Jan 4.
Bipolar disorder (BD) frequently coexists with anxiety disorders, creating complex challenges in clinical therapy and management. This study investigates the prevalence, prognostic implications, and treatment strategies for comorbid BD and anxiety disorders. High comorbidity rates, particularly with generalized anxiety disorder, underscore the necessity of thorough clinical assessments to guide effective management. Our findings suggest that anxiety disorders may serve as precursors to BD, especially in high-risk populations, making early detection of anxiety symptoms crucial for timely intervention and prevention. We also found that comorbid anxiety can negatively affect the course of BD, increasing clinical severity, reducing treatment responsiveness, and worsening prognosis. These complexities highlight the need for caution in using antidepressants, which may destabilize mood. Alternatively, cognitive-behavioral therapy presents a promising, targeted approach for managing BD with comorbid anxiety. In summary, this study provides essential insights for clinicians and researchers, enhancing understanding of BD and anxiety comorbidity and guiding more precise diagnostics and tailored interventions to improve overall patient care.
双相情感障碍（BD）常与焦虑症共存，给临床治疗和管理带来了复杂的挑战。本研究调查了双相情感障碍与焦虑症共病的患病率、预后影响及治疗策略。高共病率，尤其是与广泛性焦虑症的共病率，凸显了进行全面临床评估以指导有效管理的必要性。我们的研究结果表明，焦虑症可能是双相情感障碍的先兆，特别是在高危人群中，因此早期发现焦虑症状对于及时干预和预防至关重要。我们还发现，共病焦虑会对双相情感障碍的病程产生负面影响，增加临床严重程度，降低治疗反应性，并恶化预后。这些复杂性凸显了在使用抗抑郁药时需谨慎的必要性，因为抗抑郁药可能会使情绪不稳定。另外，认知行为疗法为管理伴有共病焦虑的双相情感障碍提供了一种有前景的、有针对性的方法。总之，本研究为临床医生和研究人员提供了重要见解，增进了对双相情感障碍与焦虑症共病的理解，并指导更精确的诊断和量身定制的干预措施，以改善整体患者护理。
