Anxiety and mood problems commonly co-occur and make diagnosis and treatment challenging. Individuals with comorbid mood and anxiety issues often have increased symptom severity and more episodes of negative affect that last longer than those that occur in individuals without comorbidity. Extensive research has been conducted exploring this dynamic in clients dealing with mood and anxiety. However, few studies have examined specific types of anxiety. Additionally, most of the studies on comorbid conditions have looked at individuals with depression. Few, if any, have looked at the comorbidity of mood and anxiety problems in individuals with bipolar. Fernando Goes of the Department of Psychiatry and Behavioral Sciences at Johns Hopkins School of Medicine in Maryland recently led a study to address this gap in research. “This study investigates clinical correlates and familiality of four anxiety disorders in a large sample of bipolar disorder (BP) and major depressive disorder (MDD) pedigrees,” said Goes. His study involved 1,416 participants with BD and 1,726 participants with MDD. Goes and his team looked at how social phobia, panic, obsessive-compulsive disorder (OCD), and specific phobias were influenced by family risk and MDD and BD.
The results revealed that the participants with the highest levels of comorbidity were those with the earliest onset ages and the most frequent number of depressive episodes. Additionally, those most at risk for comorbidity were more likely to have attempted suicide than those without comorbidity. Family history and genetic risk was a contributing factor for comorbid OCD and panic in all the participants. Although specific phobia was also linked to family history, the relationship was less significant. Family history did not influence vulnerability for comorbid social phobia. In sum, the findings clearly demonstrate that individuals with a family history of MDD or BD are at increased risk for co-occurring anxiety issues that could predict the eventual development of BD and MDD. These results could help clinicians identify individuals at risk before they experience their first episode of depression.
Goes, F., McKusker, M. G., Bienvenu, O. J., MacKinnon, D. F., Mondimore, F. M. (2012). Co-morbid anxiety disorders in bipolar disorder and major depression: Familial aggregation and clinical characteristics of co-morbid panic disorder, social phobia, specific phobia and obsessive-compulsive disorder. Psychological Medicine, 42.7, 1449-1459.
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