Citation

Pini S, Dell'Osso L, Mastrocinque C, Marcacci G, Papasogli A, Vignoli S, Pallanti S, Cassano G. Br. J. Psychiatry 1999; 175: 467-471.

Copyright

(Copyright © 1999, Royal College of Psychiatry)

DOI

10.1192/bjp.175.5.467

PMID

10789280

Abstract

BACKGROUND: Axis I comorbidities are prevalent among patients with severe bipolar disorder but the clinical and psychopathological implications are not clear. AIMS: To investigate characteristics of four groups of patients categorised as follows: substance abuse only (group 1), substance abuse associated with other Axis I disorders (group 2), non-substance-abuse Axis I comorbidity (group 3), no psychiatric comorbidity (group 4).

METHOD: Consecutive patients with bipolar disorder with psychotic features (n = 125) were assessed using the Structured Clinical Interview for DSM-III-R--patient version, and several psychopathological scales.

RESULTS: By comparison with group 4, group 1 had a higher risk of having mood-incongruent delusions, group 2 had an earlier age at onset of mood disorder, a more frequent onset with a mixed state and a higher risk of suicide, and group 3 had more severe anxiety and a better awareness of illness.

CONCLUSIONS: Substance abuse, non-substance-abuse Axis I comorbidity and their reciprocal association are associated with different characteristics of bipolar disorder.

Language: en

Keywords

Humans; Adult; Female; Male; Comorbidity; Cohort Studies; Analysis of Variance; Age of Onset; Regression Analysis; Anxiety Disorders/epidemiology; Bipolar Disorder/*epidemiology; Panic Disorder/epidemiology; Phobic Disorders/*epidemiology; Somatoform Disorders/epidemiology; Substance-Related Disorders/*epidemiology