Premium
Comorbid anxiety in bipolar disorder: does it have an independent effect on suicidality?
Author(s) -
Nakagawa Atsuo,
Grunebaum Michael F,
Sullivan Gregory M,
Currier Dianne,
Ellis Steven P,
Burke Ainsley K,
Brent David A,
Mann J John,
Oquendo Maria A
Publication year - 2008
Publication title -
bipolar disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.285
H-Index - 129
eISSN - 1399-5618
pISSN - 1398-5647
DOI - 10.1111/j.1399-5618.2008.00590.x
Subject(s) - panic disorder , bipolar disorder , anxiety , psychology , suicidal ideation , prevalence of mental disorders , psychiatry , clinical psychology , borderline personality disorder , anxiety disorder , mood disorders , comorbidity , bipolar i disorder , mood , personality disorders , psychopathology , poison control , personality , medicine , mania , suicide prevention , environmental health , social psychology
Objective: Comorbid anxiety disorder is reported to increase suicidality in bipolar disorder. However, studies of the impact of anxiety disorders on suicidal behavior in mood disorders have shown mixed results. The presence of personality disorders, often comorbid with anxiety and bipolar disorders, may explain these inconsistencies. This study examined the impact of comorbid Cluster B personality disorder and anxiety disorder on suicidality in bipolar disorder. Methods: A total of 116 depressed bipolar patients with and without lifetime anxiety disorder were compared. Multiple regression analysis tested the association of comorbid anxiety disorder with past suicide attempts and severity of suicidal ideation, adjusting for the effect of Cluster B personality disorder. The specific effect of panic disorder was also explored. Results: Bipolar patients with and without anxiety disorders did not differ in the rate of past suicide attempt. Suicidal ideation was less severe in those with anxiety disorders. In multiple regression analysis, anxiety disorder was not associated with past suicide attempts or with the severity of suicidal ideation, whereas Cluster B personality disorder was associated with both. The results were comparable when comorbid panic disorder was examined. Conclusions: Comorbid Cluster B personality disorder appears to exert a stronger influence on suicidality than comorbid anxiety disorder in persons with bipolar disorder. Assessment of suicide risk in patients with bipolar disorder should include evaluation and treatment of Cluster B psychopathology.