Social anxiety disorder comorbidity in patients with bipolar disorder: A clinical replication
Abstract
Background The authors investigated frequency, clinical correlates and onset temporal relationship of social anxiety disorder (SAD) in adult patients with a diagnosis of bipolar I disorder.Methods Subjects were 189 patients whose diagnoses were assessed by the Structured Clinical Interview for DSM-III-R-Patient Version.Results Twenty-four patients (12.7%) met DSM-III-R criteria for lifetime SAD; of these, 19 (10.1% of entire sample) had SAD within the last month. Significantly more bipolar patients with comorbid SAD also had substance use disorders compared to those without. On the HSCL-90, levels of interpersonal sensitivity, obsessiveness, phobic anxiety and paranoid ideation were significantly higher in bipolar patients with SAD than in those without. Bipolar patients with comorbid SAD recalled separation anxiety problems (school refusal) more frequently during childhood than those without. Lifetime SAD comorbidity was associated with an earlier age at onset of syndromal bipolar disorder. Pre-existing OCD tended to delay the onset of bipolarity.Conclusions Social anxiety disorder comorbidity is not rare among patients with bipolar disorder and is likely to affect age of onset and phenomenology of bipolar disorder. These findings may influence treatment planning and the possibility of discovering a pathophysiological relationship between SAD and bipolarity.
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Spontaneous remission of social anxiety is unusual in people with bipolar disorder.
“However, the fact that spontaneous remission of social anxiety is unusual in people with bipolar disorder (Pini et al. 2006) makes it unlikely.”
From Cognitive behavioural therapy for social anxiety disorder in people with bipolar disorder: a case series (2024) · cites this paper as Pini et al. 2006
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- Authors
- Pini, S., Maser, J. D., Dell’Osso, L., Abelli, M., Muti, M., Gesi, C., & Cassano, G. B.
- Affiliations
- University of Pisa (IT)
- University of California San Diego (US)
- Corresponding author
- Pini, Stefano
- Venue
- Journal of Anxiety Disorders
- Publisher
- Elsevier BV
- Published
- 2006
- Volume
- 20
- Issue
- 8
- Pages
- 1148-1157
- ISSN
- 0887-6185 (ISSN-L)
- OpenAlex
- W2059404742
- Cited by
- 37
- References
- 38
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 1 · 2019: 1 · 2018: 1 · 2016: 1 · 2015: 1 · 2014: 11 · 2013: 3 · 2012: 5
- FWCI
- 0.64
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Anxiety Disorders (publishedVersion)
- PubMed (publishedVersion)
- CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- social anxiety disorder, bipolar I disorder, comorbidities, substance use disorders, age of onset, obsessive-compulsive disorder, separation anxiety, school refusal, childhood anxiety, paranoid ideation, phobic anxiety, interpersonal sensitivity
- MeSH terms
- Adult, Bipolar Disorder, Female, Humans, Male, Phobic Disorders, Surveys and Questionnaires, Severity of Illness Index, Reproducibility of Results, Comorbidity, Diagnostic and Statistical Manual of Mental Disorders
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