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Prospective 12-month course of bipolar disorder in out-patients with and without comorbid anxiety disorders
M W Otto1, N M Simon, S R Wisniewski
1Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA. mwotto@bu.edu
Background:
The impact of anxiety disorders has not been well delineated in prospective studies of bipolar disorder.
Aims:
To examine the association between anxiety and course of bipolar disorder, as defined by mood episodes, quality of life and role functioning.
Method:
A thousand thousand out-patients with bipolar disorder were followed prospectively for 1 year.
Results:
A current comorbid anxiety disorder (present in 31.9% of participants) was associated with fewer days well, a lower likelihood of timely recovery from depression, risk of earlier relapse, lower quality of life and diminished role function over I year of prospective study. The negative impact was greater with multiple anxiety disorders.
Conclusions:
Anxiety disorders, including those present during relative euthymia, predicted a poorer bipolar course. The detrimental effects of anxiety were not simply a feature of mood state. Treatment studies targeting anxiety disorders will help to clarify the nature of the impact of anxiety on bipolar course.
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Individuals with anxiety often experience a range of physical and emotional symptoms, including sweating, trembling, tachycardia, and disturbances in sleep patterns. These symptoms vary in intensity and frequency but are generally disruptive and distressing.
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Primary Types of Anxiolytic Drugs
1. Benzodiazepines:
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Generalized Anxiety Disorder
Bipolar Disorder

