Current irritability robustly related to current and prior anxiety in bipolar disorder. (August 2016)

• Record Type: Journal Article
• Authors: Yuen, Laura D.; Miller, Shefali; Wang, Po W.; Hooshmand, Farnaz; Holtzman, Jessica N.; Goffin, Kathryn C.; Shah, Saloni; Ketter, Terence A.
• Is Part Of: Journal of psychiatric research. Volume 79(2016:Aug.)
• Page Start: 101
• Page End: 107
• Publication Date: 2016-08
• Subjects: Irritability -- Anxiety -- Bipolar disorder -- Comorbidity -- Anxiety disorder; Psychiatry -- Periodicals; Mental Disorders -- Periodicals; Maladies mentales -- Périodiques; Psychiatry; Electronic journals; Periodicals; 616.89005
• DOI: 10.1016/j.jpsychires.2016.05.006
• Languages: English
• ISSNs: 0022-3956

Abstract

Abstract: Background: Although current irritability and current/prior anxiety have been associated in unipolar depression, these relationships are less well understood in bipolar disorder (BD). We investigated relationships between current irritability and current/prior anxiety as well as other current emotions and BD illness characteristics. Methods: Outpatients referred to the Stanford Bipolar Disorders Clinic during 2000–2011 were assessed with the Systematic Treatment Enhancement Program for BD (STEP-BD) Affective Disorders Evaluation. Prevalence and clinical correlates of current irritability and current/prior anxiety and other illness characteristics were examined. Results: Among 497 BD outpatients (239 Type I, 258 Type II; 58.1% female; mean ± SD age 35.6 ± 13.1 years), 301 (60.6%) had baseline current irritability. Patients with versus without current irritability had significantly higher rates of current anxiety (77.1% versus 42.9%, p < 0.0001) and history of anxiety disorder (73.1% versus 52.6%, p < 0.0001). Current irritability was more robustly related to current anxiety than to current anhedonia, sadness, or euphoria (all p < 0.001), and current irritability-current anxiety associations persisted across current predominant mood states. Current irritability was more robustly related to past anxiety than to all other assessed illness characteristics, including 1° family history of mood disorder, history of alcohol/substance use disorder, bipolar subtype, and current syndromal/subsyndromal depression (all p < 0.05). Limitations: Limited generalizability beyond our predominately white, female, educated, insured American BD specialty clinic sample. Conclusions: In BD, current irritability was robustly related to current/prior anxiety. Further studies are warranted to assess longitudinal clinical implications of relationships between irritability and anxiety in BD. Highlights: Current irritability is robustly associated with current and prior anxiety. Irritability is more strongly related to current anxiety vs. other mood symptoms. Current irritability-current anxiety associations persist across mood states. Irritability is more strongly related to past anxiety vs. other BD characteristics.