Current irritability robustly related to current and prior anxiety in bipolar disorder.
BACKGROUND
Although current irritability and current/prior anxiety have been associated in unipolar depression, these relationships are less well understood in bipolar disorder (BD). We investigated relationships between current irritability and current/prior anxiety as well as other current emotions and BD illness characteristics.


METHODS
Outpatients referred to the Stanford Bipolar Disorders Clinic during 2000-2011 were assessed with the Systematic Treatment Enhancement Program for BD (STEP-BD) Affective Disorders Evaluation. Prevalence and clinical correlates of current irritability and current/prior anxiety and other illness characteristics were examined.


RESULTS
Among 497 BD outpatients (239 Type I, 258 Type II; 58.1% female; mean ± SD age 35.6 ± 13.1 years), 301 (60.6%) had baseline current irritability. Patients with versus without current irritability had significantly higher rates of current anxiety (77.1% versus 42.9%, p < 0.0001) and history of anxiety disorder (73.1% versus 52.6%, p < 0.0001). Current irritability was more robustly related to current anxiety than to current anhedonia, sadness, or euphoria (all p < 0.001), and current irritability-current anxiety associations persisted across current predominant mood states. Current irritability was more robustly related to past anxiety than to all other assessed illness characteristics, including 1° family history of mood disorder, history of alcohol/substance use disorder, bipolar subtype, and current syndromal/subsyndromal depression (all p < 0.05).


LIMITATIONS
Limited generalizability beyond our predominately white, female, educated, insured American BD specialty clinic sample.


CONCLUSIONS
In BD, current irritability was robustly related to current/prior anxiety. Further studies are warranted to assess longitudinal clinical implications of relationships between irritability and anxiety in BD.
['Yuen|Laura D|LD|', 'Miller|Shefali|S|', 'Wang|Po W|PW|', 'Hooshmand|Farnaz|F|', 'Holtzman|Jessica N|JN|', 'Goffin|Kathryn C|KC|', 'Shah|Saloni|S|', 'Ketter|Terence A|TA|']
D000328:Adult D001007:Anxiety D001714:Bipolar Disorder D015897:Comorbidity D005260:Female D006801:Humans D007508:Irritable Mood D008297:Male D010045:Outpatients D011569:Psychiatric Status Rating Scales D011619:Psychotropic Drugs
Irritability Anxiety Bipolar disorder Anxiety disorder Comorbidity