Anxious-bipolar comorbidity - Diagnostic and treatment challenges

被引:78
作者
Perugi, G
Toni, C
Akiskal, HS
机构
[1] Univ Pisa, Inst Psychiat, I-56100 Pisa, Italy
[2] Univ Calif San Diego, Dept Psychiat, Int Mood Ctr, La Jolla, CA 92093 USA
关键词
D O I
10.1016/S0193-953X(05)70096-4
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
This article describes multiple anxiety comorbidity in the setting of unstable bipolar syndromes, associated with alcohol and substance abuse. Also described are panic attacks during mania, social phobia followed by hypomania as well as bipolar disorder manifesting as episodic obsessive-compulsive disorder The use of psychotropic combinations is necessary because of the syndromic complexity and the contrasting effects of pharmacologic treatments. The identification of differential patterns of comorbidity may provide important information in distinguishing more homogeneous clinical subtypes of affective disorders from the genetic, temperamental, and therapeutic point of view. The pattern of complex relationships among these disorders requires better-designed prospective observations. This is also true for putative temperamental (e.g. cyclothymia, interpersonal sensitivity) and personality (e.g. histrionic and borderline) factors, which might play a predisposing role in several clinically comorbid syndromes.
引用
收藏
页码:565 / +
页数:20
相关论文
共 86 条
[11]   PANIC ATTACKS IN CHRONIC-SCHIZOPHRENIA [J].
ARGYLE, N .
BRITISH JOURNAL OF PSYCHIATRY, 1990, 157 :430-433
[12]  
Association AP, 2000, DIAGNOSTIC STAT MANU, DOI [10.1176/appi.books.9780890423349, DOI 10.1176/APPI.BOOKS.9780890425596]
[13]  
BAKER RW, 1992, J CLIN PSYCHIAT, V53, P439
[14]   Atypical depression in private practice depressed outpatients: A 203-case study [J].
Benazzi, F .
COMPREHENSIVE PSYCHIATRY, 1999, 40 (01) :80-83
[15]   Prevalence of bipolar II disorder in outpatient depression: A 203-case study in private practice [J].
Benazzi, F .
JOURNAL OF AFFECTIVE DISORDERS, 1997, 43 (02) :163-166
[16]   The efficacy of 2 different dosages of methylphenidate in treating adults with attention-deficit hyperactivity disorder [J].
Bouffard, R ;
Hechtman, L ;
Minde, K ;
Iaboni-Kassab, F .
CANADIAN JOURNAL OF PSYCHIATRY-REVUE CANADIENNE DE PSYCHIATRIE, 2003, 48 (08) :546-554
[17]   PERSONALITY AS A VULNERABILITY FACTOR TO DEPRESSION [J].
BOYCE, P ;
PARKER, G ;
BARNETT, B ;
COONEY, M ;
SMITH, F .
BRITISH JOURNAL OF PSYCHIATRY, 1991, 159 :106-114
[18]  
BOYD JH, 1984, ARCH GEN PSYCHIAT, V41, P983
[19]  
BREIER A, 1984, ARCH GEN PSYCHIAT, V41, P1129
[20]   PSYCHIATRIC COMORBIDITY IN PRIMARY CARE SOMATIZATION DISORDER [J].
BROWN, FW ;
GOLDING, JM ;
SMITH, GR .
PSYCHOSOMATIC MEDICINE, 1990, 52 (04) :445-451