Francis Bennett1, Sophie Hodgetts2, Andrew Close1, Mark Frye3, Heinz Grunze4, Paul Keck5,6, Ralph Kupka7, Susan McElroy7, Willem Nolen8, Robert Post9, Lars Schärer10, Trisha Suppes11, Aditya N Sharma12,13,14. 1. Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK. 2. School of Psychology, University of Sunderland, Sunderland, UK. 3. Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA. 4. PMU Nuremberg & Psychiatrie Schwäbisch Hall, Schwäbisch Hall, Germany. 5. Linder Center of Hope, Mason, OH, USA. 6. Biological Psychiatry Program, University of Cincinnati Medical College, Cincinnati, OH, USA. 7. Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands. 8. University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 9. Bipolar Collaborative Network, Bethesda, MD, USA. 10. Department of Psychiatry, and Psychotherapy Medical Center, University of Freiburg, Faculty of Medicine, Freiburg im Breisgau, Germany. 11. School of Medicine and V.A. Palo Alto Health Care System Palo Alto, Stanford University, Palo Alto, CA, USA. 12. Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK. aditya.sharma@ncl.ac.uk. 13. Northumberland Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK. aditya.sharma@ncl.ac.uk. 14. Academic Psychiatry, Wolfson Research Centre, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK. aditya.sharma@ncl.ac.uk.
Abstract
BACKGROUND: Impairments in psychosocial functioning have been demonstrated in 30-60% of adults with bipolar disorder (BD). However, the majority of studies investigating the effect of comorbid mental health disorders and age at onset outcomes in BD have focused on traditional outcome measures such as mood symptoms, mortality and treatment response. Therefore, this project aimed to investigate the impact of comorbid mental health disorders and age at onset on longitudinal psychosocial outcome in participants with BD. METHOD: Mixed effects modelling was conducted using data from the Stanley Foundation Bipolar Network. Baseline factors were entered into a model, with Global Assessment of Functioning (GAF) score as the longitudinal outcome measure. Relative model fits were calculated using Akaike's Information Criterion. RESULTS: No individual comorbidities predicted lower GAF scores, however an interaction effect was demonstrated between attention deficit hyperactivity disorder (ADHD) and any anxiety disorder (t = 2.180, p = 0.030). Participants with BD I vs BD II (t = 2.023, p = 0.044) and those in the lowest vs. highest income class (t = 2.266, p = 0.024) predicted lower GAF scores. Age at onset (t = 1.672, p = 0.095) did not significantly predict GAF scores. CONCLUSIONS: This is the first study to demonstrate the negative psychosocial effects of comorbid anxiety disorders and ADHD in BD. This study adds to the growing database suggesting that comorbid mental health disorders are a significant factor hindering psychosocial recovery.
BACKGROUND:Impairments in psychosocial functioning have been demonstrated in 30-60% of adults with bipolar disorder (BD). However, the majority of studies investigating the effect of comorbid mental health disorders and age at onset outcomes in BD have focused on traditional outcome measures such as mood symptoms, mortality and treatment response. Therefore, this project aimed to investigate the impact of comorbid mental health disorders and age at onset on longitudinal psychosocial outcome in participants with BD. METHOD: Mixed effects modelling was conducted using data from the Stanley Foundation Bipolar Network. Baseline factors were entered into a model, with Global Assessment of Functioning (GAF) score as the longitudinal outcome measure. Relative model fits were calculated using Akaike's Information Criterion. RESULTS: No individual comorbidities predicted lower GAF scores, however an interaction effect was demonstrated between attention deficit hyperactivity disorder (ADHD) and any anxiety disorder (t = 2.180, p = 0.030). Participants with BD I vs BD II (t = 2.023, p = 0.044) and those in the lowest vs. highest income class (t = 2.266, p = 0.024) predicted lower GAF scores. Age at onset (t = 1.672, p = 0.095) did not significantly predict GAF scores. CONCLUSIONS: This is the first study to demonstrate the negative psychosocial effects of comorbid anxiety disorders and ADHD in BD. This study adds to the growing database suggesting that comorbid mental health disorders are a significant factor hindering psychosocial recovery.
Entities:
Keywords:
Bipolar disorder; Comorbidity; Social functioning
Authors: Petri Arvilommi; Sanna Pallaskorpi; Outi Linnaranta; Kirsi Suominen; Sami Leppämäki; Hanna Valtonen; Erkki Isometsä Journal: Int J Bipolar Disord Date: 2022-07-11