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
Open accessAbstract
Background: Co-morbidity of mood and anxiety disorders is common and often associated with greater illness severity. 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. Method: The sample comprised 566 BP families with 1416 affected subjects and 675 MDD families with 1726 affected subjects. Clinical characteristics and familiality of panic disorder, social phobia, specific phobia and obsessive-compulsive disorder (OCD) were examined in BP and MDD pedigrees with multivariate modeling using generalized estimating equations. Results: Co-morbidity between mood and anxiety disorders was associated with several markers of clinical severity, including earlier age of onset, greater number of depressive episodes and higher prevalence of attempted suicide, when compared with mood disorder without co-morbid anxiety. Familial aggregation was found with co-morbid panic and OCD in both BP and MDD pedigrees. Specific phobia showed familial aggregation in both MDD and BP families, although the findings in BP were just short of statistical significance after adjusting for other anxiety co-morbidities. We found no evidence for familiality of social phobia. Conclusions: Our findings suggest that co-morbidity of MDD and BP with specific anxiety disorders (OCD, panic disorder and specific phobia) is at least partly due to familial factors, which may be of relevance to both phenotypic and genetic studies of co-morbidity.
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When diagnosed comorbidly with bipolar disorder, obsessive compulsive disorder has been associated with an earlier onset of bipolar disorder, a higher number of previous mood episodes, rapid cycling, seasonality, substance misuse, and lower overall functioning.
“When diagnosed comorbidly with BD, OCD has been associated with an earlier onset of BD, a higher number of previous mood episodes, rapid cycling, seasonality, substance misuse, and lower overall functioning.732, 737, 738, 739, 740, 741, 742”
From Canadian Network for Mood and Anxiety Treatments ( <scp>CANMAT</scp> ) and International Society for Bipolar Disorders ( <scp>ISBD</scp> ) 2018 guidelines for the management of patients with bipolar disorder (2018) · cites this paper as [738]
The Results (page not provided) associate comorbid OCD in the bipolar sample with earlier onset of depressive episodes and more depressive episodes. They do not establish earlier onset of bipolar disorder itself or address rapid cycling, seasonality, substance misuse, or overall functioning; the copy describes greater clinical severity but not a functioning measure. (LLM, conf=0.88)
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References 55 · Cited by 136
- Authors
- Goes, F. S., McCusker, M. G., Bienvenu, O. J., MacKinnon, D. F., Mondimore, F. M., Schweizer, B., National Institute of Mental Health Genetics Initiative Bipolar Disorder Consortium, DePaulo, J. R., & Potash, J. B.
- Affiliations
- Johns Hopkins University (US)
- University of Iowa (US)
- Corresponding author
- Goes, F. S.
- ORCID
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2011-11-21
- Volume
- 42
- Issue
- 7
- Pages
- 1449-1459
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- PMC
- PMC3643205
- OpenAlex
- W1982387098
- Cited by
- 136
- References
- 55
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 3 · 2023: 8 · 2022: 7 · 2021: 8 · 2020: 13 · 2019: 11 · 2018: 13 · 2017: 9 · 2016: 11 · 2015: 9 · 2014: 18 · 2013: 10 · 2012: 5
- FWCI
- 7.44
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
- Funders
- National Institutes of Health (5u01mh046280-08, 5u01mh046274-08)
- National Institute of Mental Health (R01MH59533, R01 MH60068, R01MH59545, R01 MH59553, K99MH086049, R01 MH59567, R01MH059553, K99MH86049, R01MH059541, R01 MH 59535, Z01MH002810, R01MH059545, U01MH46282, R01MH059542, R01MH059534, R01MH059533, U01MH046282, R01MH059567, R01MH059556, R01 MH61686, R01MH060866, R01MH059535, U01 MH 46280, R01MH059548, R01MH060912, R01MH060068, R01MH059552, R01MH061686, U01 MH 46274)
- 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 › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- bipolar disorder, major depressive disorder, anxiety disorders, comorbidities, panic disorder, social anxiety disorder, specific phobia, obsessive-compulsive disorder, familial aggregation, genetic susceptibility, clinical severity, age of onset, suicide attempts, depressive episodes
- MeSH terms
- Adult, Anxiety Disorders, Bipolar Disorder, Major Depressive Disorder, Female, Humans, Interview, Psychological, Male, Pedigree, Severity of Illness Index, Models, Statistical, Comorbidity, Multivariate Analysis, Genetic Predisposition to Disease
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