TY - JOUR
T1 - Empirically derived subgroups of bipolar i patients with different comorbidity patterns of anxiety and substance use disorders in Han Chinese population
AU - Tsai, Han Chieh
AU - Lu, Ming Kun
AU - Yang, Yen Kuang
AU - Huang, Ming Chyi
AU - Yeh, Tzung Lieh
AU - Chen, Wei Jen
AU - Lu, Ru Band
AU - Kuo, Po Hsiu
N1 - Funding Information:
Funding for present study was supported by National Science Council grants HR-96-53 , NSC 97-2314-B-002-184-MY2 , NSC 99-2314-B-002-140-MY3 , Department of Health Taipei City Government grant 97002-62-045 , and National Health Research Institute grant EX99-9918NC to Kuo, P.H. The funding sources had no further role in the study design, collection, analysis, or interpretation of data, in writing of the report, and in the decision to submit the paper for publication.
PY - 2012/1
Y1 - 2012/1
N2 - Objective: Bipolar-I disorder (BPI) often co-occurred with anxiety (ANX) and substance use disorders (SUD), which poses challenges in public health and clinical treatment, and adds complexity in searching for relevant etiologic factors. The present study sought to identify subgroups of BPI patients using comorbidity patterns with ANX and SUD. Methods: Clinical patients (N = 306) diagnosed with BPI were recruited and interviewed using the Composite International Diagnostic Interview to collect data on demographics and clinical features, including episodic information, impairments, and lifetime diagnoses of ANX (panic, agoraphobia, generalized anxiety disorder, specific and social phobia) and SUD (nicotine dependence, alcohol use and drug use disorder). We applied latent class analysis to empirically derive classes of BPI. A number of exogenous variables were examined for each class. Results: A three-class model provides excellent discriminability for subgrouping BPI patients with different comorbidity patterns. The BPI-LOW class (83.99%) had more pure mania without most lifetime comorbidity, higher numbers of last year mania episodes, and less suicidality and impairments. The BPI-ANX class (3.60%) was female predominant, tended to comorbid with multiple anxiety disorders but no SUD, and had early onset age. The BPI-SUD class (12.42%) was male predominant, had high prevalence of lifetime SUD and frequent mood episodes in the last year. Both the BPI-ANX and BPI-SUD classes had severe functional impairments and suicidal behaviors. Limitations: Clinical information was retrospectively collected. Besides, we did not comprehensively access lifetime comorbidity for all psychiatric disorders. Conclusion: The three empirically identified subgroups of BPI patients exhibited distinguished comorbidity patterns and clinical features, including suicidal behaviors, frequent mood episodes and functional impairments. Our findings have clinical implication in intervention and treatment as well as to explore their different underlying mechanisms.
AB - Objective: Bipolar-I disorder (BPI) often co-occurred with anxiety (ANX) and substance use disorders (SUD), which poses challenges in public health and clinical treatment, and adds complexity in searching for relevant etiologic factors. The present study sought to identify subgroups of BPI patients using comorbidity patterns with ANX and SUD. Methods: Clinical patients (N = 306) diagnosed with BPI were recruited and interviewed using the Composite International Diagnostic Interview to collect data on demographics and clinical features, including episodic information, impairments, and lifetime diagnoses of ANX (panic, agoraphobia, generalized anxiety disorder, specific and social phobia) and SUD (nicotine dependence, alcohol use and drug use disorder). We applied latent class analysis to empirically derive classes of BPI. A number of exogenous variables were examined for each class. Results: A three-class model provides excellent discriminability for subgrouping BPI patients with different comorbidity patterns. The BPI-LOW class (83.99%) had more pure mania without most lifetime comorbidity, higher numbers of last year mania episodes, and less suicidality and impairments. The BPI-ANX class (3.60%) was female predominant, tended to comorbid with multiple anxiety disorders but no SUD, and had early onset age. The BPI-SUD class (12.42%) was male predominant, had high prevalence of lifetime SUD and frequent mood episodes in the last year. Both the BPI-ANX and BPI-SUD classes had severe functional impairments and suicidal behaviors. Limitations: Clinical information was retrospectively collected. Besides, we did not comprehensively access lifetime comorbidity for all psychiatric disorders. Conclusion: The three empirically identified subgroups of BPI patients exhibited distinguished comorbidity patterns and clinical features, including suicidal behaviors, frequent mood episodes and functional impairments. Our findings have clinical implication in intervention and treatment as well as to explore their different underlying mechanisms.
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U2 - 10.1016/j.jad.2011.08.015
DO - 10.1016/j.jad.2011.08.015
M3 - Article
C2 - 21906818
AN - SCOPUS:84856878052
SN - 0165-0327
VL - 136
SP - 81
EP - 89
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
IS - 1-2
ER -