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Prevalence and distinct correlates of anxiety, substance, and combined comorbidity in a multi-site public sector sample with bipolar disorder.
J Affect Disord. 2005 Apr; 85(3):301-15.JA

Abstract

BACKGROUND

Recent data indicate high prevalence of both anxiety and substance comorbidity in bipolar disorder. However, few studies have utilized public sector samples, and only one has attempted to separate contributions of each type of comorbidity.

METHODS

328 inpatient veterans with bipolar disorder across 11 sites were assessed using selected Structured Clinical Interview for DSM-IV modules and self-reports.

RESULTS

Comorbidity was common (current: 57.3%; lifetime: 78.4%), with multiple current comorbidities in 29.8%. Substance comorbidity rate was comparable to rates typically reported in non-veteran inpatient samples (33.8% current, 72.3% lifetime). Selected anxiety comorbidity rates exceeded those in other inpatient samples and appeared more chronic than episodic/recurrent (38.3% current, 43.3% lifetime). 49% of PTSD was due to non-combat stressors. Major correlates of current substance comorbidity alone were younger age, worse marital status, and higher current employability. Correlates of current anxiety comorbidity alone were early age of onset, greater number of prior-year depressive episodes, higher rates of disability pension receipt, and lower self-reported mental and physical function. Combined comorbidity resembled anxiety comorbidity.

LIMITATIONS

This is a cross-sectional analysis of acutely hospitalized veterans.

CONCLUSIONS

Distinct patterns of substance and anxiety comorbidity are striking, and may be subserved by distinct neurobiologic mechanisms. The prevalence, chronicity and functional impact of anxiety disorders indicate the need for improved recognition and treatment of this other dual diagnosis group is warranted. Clinical and research interventions should recognize these divergent comorbidity patterns and provide individualized treatment built "from the patient out."

Authors+Show Affiliations

VAMC and Brown University, 116R, 830 Chalkstone Avenue, Providence, RI 02908-4799, USA. mark.bauer@med.va.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15780700

Citation

Bauer, Mark S., et al. "Prevalence and Distinct Correlates of Anxiety, Substance, and Combined Comorbidity in a Multi-site Public Sector Sample With Bipolar Disorder." Journal of Affective Disorders, vol. 85, no. 3, 2005, pp. 301-15.
Bauer MS, Altshuler L, Evans DR, et al. Prevalence and distinct correlates of anxiety, substance, and combined comorbidity in a multi-site public sector sample with bipolar disorder. J Affect Disord. 2005;85(3):301-15.
Bauer, M. S., Altshuler, L., Evans, D. R., Beresford, T., Williford, W. O., & Hauger, R. (2005). Prevalence and distinct correlates of anxiety, substance, and combined comorbidity in a multi-site public sector sample with bipolar disorder. Journal of Affective Disorders, 85(3), 301-15.
Bauer MS, et al. Prevalence and Distinct Correlates of Anxiety, Substance, and Combined Comorbidity in a Multi-site Public Sector Sample With Bipolar Disorder. J Affect Disord. 2005;85(3):301-15. PubMed PMID: 15780700.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence and distinct correlates of anxiety, substance, and combined comorbidity in a multi-site public sector sample with bipolar disorder. AU - Bauer,Mark S, AU - Altshuler,Lori, AU - Evans,Denise R, AU - Beresford,Thomas, AU - Williford,William O, AU - Hauger,Richard, AU - ,, PY - 2004/04/12/received PY - 2004/11/30/accepted PY - 2005/3/23/pubmed PY - 2005/9/10/medline PY - 2005/3/23/entrez SP - 301 EP - 15 JF - Journal of affective disorders JO - J Affect Disord VL - 85 IS - 3 N2 - BACKGROUND: Recent data indicate high prevalence of both anxiety and substance comorbidity in bipolar disorder. However, few studies have utilized public sector samples, and only one has attempted to separate contributions of each type of comorbidity. METHODS: 328 inpatient veterans with bipolar disorder across 11 sites were assessed using selected Structured Clinical Interview for DSM-IV modules and self-reports. RESULTS: Comorbidity was common (current: 57.3%; lifetime: 78.4%), with multiple current comorbidities in 29.8%. Substance comorbidity rate was comparable to rates typically reported in non-veteran inpatient samples (33.8% current, 72.3% lifetime). Selected anxiety comorbidity rates exceeded those in other inpatient samples and appeared more chronic than episodic/recurrent (38.3% current, 43.3% lifetime). 49% of PTSD was due to non-combat stressors. Major correlates of current substance comorbidity alone were younger age, worse marital status, and higher current employability. Correlates of current anxiety comorbidity alone were early age of onset, greater number of prior-year depressive episodes, higher rates of disability pension receipt, and lower self-reported mental and physical function. Combined comorbidity resembled anxiety comorbidity. LIMITATIONS: This is a cross-sectional analysis of acutely hospitalized veterans. CONCLUSIONS: Distinct patterns of substance and anxiety comorbidity are striking, and may be subserved by distinct neurobiologic mechanisms. The prevalence, chronicity and functional impact of anxiety disorders indicate the need for improved recognition and treatment of this other dual diagnosis group is warranted. Clinical and research interventions should recognize these divergent comorbidity patterns and provide individualized treatment built "from the patient out." SN - 0165-0327 UR - https://www.unboundmedicine.com/medline/citation/15780700/Prevalence_and_distinct_correlates_of_anxiety_substance_and_combined_comorbidity_in_a_multi_site_public_sector_sample_with_bipolar_disorder_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-0327(04)00437-9 DB - PRIME DP - Unbound Medicine ER -