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Social anxiety disorder comorbidity in patients with bipolar disorder: a clinical replication
Authors:Pini Stefano  Maser Jack D  Dell'Osso Liliana  Abelli Marianna  Muti Matteo  Gesi Camilla  Cassano Giovanni B
Affiliation:Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, via Roma 65, I-56100 Pisa, Italy.
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.
Keywords:Social anxiety disorder   Bipolar disorder   Separation anxiety disorder   Panic disorder   Comorbidity   Age at onset
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