TORONTO – Children and teens with bipolar disorder had a significantly longer recovery time and more recurrences if they had comorbid anxiety disorders, based on data from a longitudinal study.
Comorbid anxiety disorder has been previously associated with worse prognosis in teens with bipolar disorders, but the finding has based primarily on cross-sectional studies, and longitudinal data are limited, said Dr. Regina Sala of Columbia University in New York and her colleagues.
Data from the Course and Outcomes of Bipolar Youth study were reviewed for 413 youth aged 7-17 years (average age 13 years) with bipolar disorder; 256 study participants had comorbid anxiety.
The patients were assessed weekly for 5 years. After researchers adjusted for confounding variables, 37% of the children and teens with comorbid anxiety disorders and 55% of those without anxiety were asymptomatic on a weekly basis.
In addition, bipolar youth with comorbid anxiety took significantly longer to recover from their index episodes; the median times to recovery were 138 weeks for those with anxiety and 87 weeks for those without anxiety. Recurrence rates also were significantly higher at 76% for bipolar youth with comorbid anxiety and 57% for those without comorbid anxiety. The median time to recurrence was significantly shorter at 37 weeks in the comorbid group and 48 weeks with bipolar disorder alone.
The results suggest that characteristics of youth with comorbid bipolar and anxiety disorders include more syndromal and subsyndromal mixed cycling, more depression, and less euthymia than did bipolar youth without comorbid anxiety, the researchers said.
Dr. Sala was supported by a grant from the Alicia Koplowitz Foundation. Several study coauthors have received financial support and/or served as consultants or on advisory boards for multiple companies including Pfizer, Abbott, Schering-Plough, Bristol-Myers Squibb, and Forest.