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Anxiety symptoms in a major mood and schizophrenia spectrum disorders

Published online by Cambridge University Press:  23 March 2020

B. Karpov ,
G. Joffe ,
K. Aaltonen ,
J. Suvisaari ,
I. Baryshnikov ,
P. Näätänen ,
M. Koivisto ,
T. Melartin ,
J. Oksanen  and
K. Suominen
...Show all authors
B. Karpov
Affiliation:
Department of Psychiatry, University of Helsinki, Helsinki University Hospital, PO Box 22 (Välskärinkatu 12 A)Helsinki00014, Finland
G. Joffe
Affiliation:
Department of Psychiatry, University of Helsinki, Helsinki University Hospital, PO Box 22 (Välskärinkatu 12 A)Helsinki00014, Finland
K. Aaltonen
Affiliation:
Department of Psychiatry, University of Helsinki, Helsinki University Hospital, PO Box 22 (Välskärinkatu 12 A)Helsinki00014, Finland
J. Suvisaari
Affiliation:
Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Mannerheimintie 166Helsinki00271, Finland
I. Baryshnikov
Affiliation:
Department of Psychiatry, University of Helsinki, Helsinki University Hospital, PO Box 22 (Välskärinkatu 12 A)Helsinki00014, Finland
P. Näätänen
Affiliation:
Department of Psychiatry, University of Helsinki, Helsinki University Hospital, PO Box 22 (Välskärinkatu 12 A)Helsinki00014, Finland
M. Koivisto
Affiliation:
Department of Psychiatry, University of Helsinki, Helsinki University Hospital, PO Box 22 (Välskärinkatu 12 A)Helsinki00014, Finland
T. Melartin
Affiliation:
Department of Psychiatry, Helsinki University Central Hospital, PO Box 590Helsinki00029, Finland
J. Oksanen
Affiliation:
Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Mannerheimintie 166Helsinki00271, Finland
K. Suominen
Affiliation:
Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Mannerheimintie 166Helsinki00271, Finland Department of Social Services and Health Care, Helsinki, Finland
M. Heikkinen
Affiliation:
Department of Psychiatry, University of Helsinki, Helsinki University Hospital, PO Box 22 (Välskärinkatu 12 A)Helsinki00014, Finland
T. Paunio
Affiliation:
Department of Psychiatry, University of Helsinki, Helsinki University Hospital, PO Box 22 (Välskärinkatu 12 A)Helsinki00014, Finland Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Mannerheimintie 166Helsinki00271, Finland
E. Isometsä*
Affiliation:
Department of Psychiatry, University of Helsinki, Helsinki University Hospital, PO Box 22 (Välskärinkatu 12 A)Helsinki00014, Finland Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Mannerheimintie 166Helsinki00271, Finland
*
* Corresponding author. Tel.: +358 9 4711; fax: +358 9 471 6373. E-mail address:[email protected] (E. Isometsä).
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Abstract

Background

Comorbid anxiety symptoms and disorders are present in many psychiatric disorders, but methodological variations render comparisons of their frequency and intensity difficult. Furthermore, whether risk factors for comorbid anxiety symptoms are similar in patients with mood disorders and schizophrenia spectrum disorders remains unclear.

Methods

The Overall Anxiety Severity and Impairment Scale (OASIS) was used to measure anxiety symptoms in psychiatric care patients with schizophrenia or schizoaffective disorder (SSA, n = 113), bipolar disorder (BD, n = 99), or depressive disorder (DD, n = 188) in the Helsinki University Psychiatric Consortium Study. Bivariate correlations and multivariate linear regression models were used to examine associations of depressive symptoms, neuroticism, early psychological trauma and distress, self-efficacy, symptoms of borderline personality disorder, and attachment style with anxiety symptoms in the three diagnostic groups.

Results

Frequent or constant anxiety was reported by 40.2% of SSA, 51.5% of BD, and 55.6% of DD patients; it was described as severe or extreme by 43.8%, 41.4%, and 41.2% of these patients, respectively. SSA patients were significantly less anxious (P = 0.010) and less often avoided anxiety-provoking situations (P = 0.009) than the other patients. In regression analyses, OASIS was associated with high neuroticism, symptoms of depression and borderline personality disorder and low self-efficacy in all patients, and with early trauma in patients with mood disorders.

Conclusions

Comorbid anxiety symptoms are ubiquitous among psychiatric patients with mood or schizophrenia spectrum disorders, and in almost half of them, reportedly severe. Anxiety symptoms appear to be strongly related to both concurrent depressive symptoms and personality characteristics, regardless of principal diagnosis.

Keywords

AnxietySchizophreniaBipolar disorderDepressionComorbidity
Type
Original article
Information
European Psychiatry , Volume 37 , September 2016 , pp. 1 - 7
Copyright
Copyright © European Psychiatric Association 2016

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Footnotes

1

Tel: +358 9 4711.

2

Tel: +358 29 524 6000.

3

Tel: +358 9 4711; fax: +358 9 471 63735.

4

Tel: +358 40 771 8354.

References

Öhman, AFear and anxiety: overlaps and dissociationsLewis, MHaviland-Jones, JMBarrett, LFHandbook of emotions. The Guilford Press New York, 2008 709–730Google Scholar
Kessler, RCChiu, WTDemler, OWalters, EEPrevalence, Severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Arch Gen Psychiatry 2005; 62(6): 617–627CrossRefGoogle Scholar
Kessler, RCAguilar-Gaxiola, SAlonso, JChatterji, SLee, SOrmel, Jet al.The global burden of mental disorders: an update from the WHO World Mental Health (WMH) Surveys Epidemiol Psichiatr Soc 2009; 18(1): 23–33CrossRefGoogle ScholarPubMed
Wittchen, HUJacobi, FRehm, JGustavsson, ASvensson, MJönsson, Bet al.The size and burden of mental disorders and other disorders of the brain in Europe 2010 Eur Neuropsychopharmacol 2011; 21(9): 655–679CrossRefGoogle ScholarPubMed
Pirkola, SPIsometsä, ETSuvisaari, JAro, HJoukamaa, MPoikolainen, Ket al.DSM-IV mood-, anxiety- and alcohol use disorders and their comorbidity in the Finnish general population. Results from the Health 2000 Study Soc Psychiatry Psychiatr Epidemiol 2005; 40(1): 1–10CrossRefGoogle ScholarPubMed
Achim, AMMaziade, MRaymond, EOlivier, DMerette, CRoy, MAHow prevalent are anxiety disorders in schizophrenia? A meta-analysis and critical review on a significant association. Schizophr Bull 2011; 37(4): 811–821CrossRefGoogle ScholarPubMed
Pavlova, BPerlis, RHAlda, MUher, RLifetime prevalence of anxiety disorders in people with bipolar disorder: a systematic review and meta-analysis. Lancet Psychiatry 2015; 2(8): 710–717CrossRefGoogle ScholarPubMed
Brown, TACampbell, LALehman, CLGrisham, JRMancill, RBCurrent and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample. J Abnorm Psychol 2001; 110(4): 585–599CrossRefGoogle Scholar
Braga, RJReynolds, GPSiris, SGAnxiety comorbidity in schizophrenia. Psychiatry Res 2013; 210(1): 1–7CrossRefGoogle Scholar
El-Mallakh, RSHollifield, MComorbid anxiety in bipolar disorder alters treatment prognosis. Psychiatr Q 2008; 79(2): 139–150CrossRefGoogle Scholar
Braam, AWCopeland, JRDelespaul, PABeekman, ATComo, ADewey, Met al.Depression, subthreshold depression and comorbid anxiety symptoms in older Europeans: results from the EURODEP concerted action J Affect Disord 2014; 155: 266–272CrossRefGoogle ScholarPubMed
Saarni, SISuvisaari, JSintonen, HPirkola, SKoskinen, SAromaa, Aet al.Impact of psychiatric disorders on health-related quality of life: general population survey Br J Psychiatry 2007; 190: 326–332CrossRefGoogle ScholarPubMed
Comer, JSBlanco, CHasin, DSLiu, S.-M.Grant, BFTurner, JBet al.Health-related quality of life across the anxiety disorders J Clin Psychiatry 2011; 72(1): 43–50CrossRefGoogle ScholarPubMed
Karsten, JPenninx, BWVerboom, CENolen, WAHartman, CACourse and risk factors of functional impairment in subthreshold depression and anxiety. Depress Anxiety 2013; 30(4): 386–394CrossRefGoogle ScholarPubMed
Miloyan, BByrne, GJPachana, NAThreshold and subthreshold generalized anxiety disorder in later life. Am J Geriatr Psychiatry 2015; 23(6): 633–641CrossRefGoogle ScholarPubMed
Weiller, EBisserbe, JCMaier, WLecrubier, YPrevalence and recognition of anxiety syndromes in five European primary care settings: a report from the WHO study on psychological problems in general health care. Br J Psychiatry Suppl 1998; 34: 18–23CrossRefGoogle Scholar
Mantere, OMelartin, TKSuominen, KRytsala, HJValtonen, HMArvilommi, Pet al.Differences in Axis I and II comorbidity between bipolar I and II disorders and major depressive disorder J Clin Psychiatry 2006; 67(4): 584–593CrossRefGoogle ScholarPubMed
Melartin, TKRytsala, HJLeskela, USLestela-Mielonen, PSSokero, TPIsometsa, ETCurrent comorbidity of psychiatric disorders among DSM-IV major depressive disorder patients in psychiatric care in the Vantaa Depression Study. J Clin Psychiatry 2002; 63(2): 126–134CrossRefGoogle ScholarPubMed
Lysaker, PHSalyers, MPAnxiety symptoms in schizophrenia spectrum disorders: associations with social function, positive and negative symptoms, hope and trauma history. Acta Psychiatr Scand. 2007; 114(4): 290–298CrossRefGoogle Scholar
Krueger, RFCaspi, AMoffitt, TESilva, PAThe structure and stability of common mental disorders (DSM-III-R): a longitudinal-epidemiological study. J. Abnorm Psychol 1998; 107(2): 216–227CrossRefGoogle Scholar
Krueger, RFThe structure of common mental disorders. Arch Gen Psychiatry 1999; 56(10): 921–926CrossRefGoogle ScholarPubMed
Melartin, TMantere, OKetokivi, MIsometsä, EA prospective latent analysis study of Axis I psychiatric co-morbidity of DSM-IV major depressive disorder. Psychol Med 2014; 44(5): 949–959CrossRefGoogle ScholarPubMed
Eaton, NRKrueger, RFMarkon, KEKeyes, KMSkodol, AEWall, Met al.The structure and predictive validity of the internalizing disorders J Abnorm Psychol 2013; 122(1): 86–92CrossRefGoogle ScholarPubMed
Kessler, RCOrmel, JPetukhova, MMcLaughlin, KAGreen, JGRusso, LJet al.Development of lifetime comorbidity in the WHO World Mental Health (WMH) Surveys Arch Gen Psychiatry 2011; 68(1): 90–100CrossRefGoogle Scholar
Kendler, KSAggen, SHKnudsen, GPRøysamb, ENeale, MCReichborn-Kjennerud, TThe structure of genetic and environmental risk factors for syndromal and subsyndromal common DSM-IV axis I and all axis II disorders. Am J Psychiatry 2011; 168(1): 29–39CrossRefGoogle ScholarPubMed
Hettema, JMWhat is the genetic relationship between anxiety and depression?. Am J Med Genet C 2008; 148C(2):140–146CrossRefGoogle ScholarPubMed
Mantere, OSoronen, PUher, RKetokivi, MJylha, PMelartin, Tet al.Neuroticism mediates the effect of P2RX7 on outcomes of mood disorders Depress Anxiety 2012; 29(9): 816–823CrossRefGoogle ScholarPubMed
Ormel, JJeronimus, BFKotov, RRiese, HBos, EHHankin, Bet al.Neuroticism and common mental disorders: meaning and utility of a complex relationship Clin Psychol Rev 2013; 33(5): 686–697CrossRefGoogle ScholarPubMed
Griffith, JWZinbarg, RECraske, MGMineka, SRose, RDWaters, AMet al.Neuroticism as a common dimension in the internalizing disorders Psychol Med 2010; 40(7): 1125–1136CrossRefGoogle ScholarPubMed
de Moor, MHvan den Berg, SMVerweij, KJKrueger, RFLuciano, MArias Vasquez, Aet al.Meta-analysis of genome-wide association studies for neuroticism, and the polygenic association with major depressive disorder JAMA Psychiatry 2015; 72(7): 642–650Google ScholarPubMed
Hovens, JGGiltay, EJWiersma, JESpinhoven, PPenninx, BWZitman, FGImpact of childhood life events and trauma on the course of depressive and anxiety disorders. Acta Psychiatr Scand 2012; 126(3): 198–207CrossRefGoogle ScholarPubMed
Richards, JCRichardson, VPier, CThe relative contributions of negative cognitions and self-efficacy to severity of panic attacks in panic disorder. Behav Change 2002; 19(2): 102–111CrossRefGoogle Scholar
De Las Cuevas, CPenate, WSanz, EJThe relationship of psychological reactance, health locus of control and sense of self-efficacy with adherence to treatment in psychiatric outpatients with depression. BMC Psychiatry 14 2014 324CrossRefGoogle ScholarPubMed
Zanarini, MCFrankenburg, FRDubo, EDSickel, AETrikha, ALevin, Aet al.comorbidity of borderline personality disorder Am J Psychiatry 1998; 155(12): 1733–1739CrossRefGoogle ScholarPubMed
Marazziti, DDell’osso, BCatena Dell’Osso, MConsoli, GDel Debbio, AMungai, Fet al.Romantic attachment in patients with mood and anxiety disorders CNS Spectr 2007; 12(10): 751–756CrossRefGoogle ScholarPubMed
Van Os, JJones, PBNeuroticism as a risk factor for schizophrenia. Psychol Med 2001; 31(6): 1129–1134CrossRefGoogle Scholar
Larsson, SAndreassen, OAAas, MRøssberg, JIMork, ESteen, NEet al.High prevalence of childhood trauma in patients with schizophrenia spectrum and affective disorder Compr Psychiatry 2013; 54(2): 123–127CrossRefGoogle ScholarPubMed
Kurtz, MMOlfson, RHRose, JSelf-efficacy and functional status in schizophrenia: relationship to insight, cognition and negative symptoms. Schizophr Res 2013; 145(1–3):69–74CrossRefGoogle ScholarPubMed
Bahorik, ALEack, SMExamining the course and outcome of individuals diagnosed with schizophrenia and comorbid borderline personality disorder. Schizophr Res 2010; 124(1–3):29–35CrossRefGoogle ScholarPubMed
International classification of disease 10th ed.1992World Health Organization GenevaGoogle Scholar
Norman, SBCissell, SHMeans-Christensen, AJStein, MBDevelopment and validation of an Overall Anxiety Severity and Impairment Scale (OASIS). Depress Anxiety 2006; 23(4): 245–249CrossRefGoogle Scholar
Campbell-Sills, LNorman, SBCraske, MGSullivan, GLang, AJChavira, DAet al.Validation of a brief measure of anxiety-related severity and impairment: the Overall Anxiety Severity and Impairment Scale (OASIS). J Affect Disord 2009; 112(1–3):92–101CrossRefGoogle Scholar
Beck, ATWard, CHMendelson, MMock, JErbaugh, JAn inventory for measuring depression. Arch Gen Psychiatry 1961; 4: 561–571CrossRefGoogle ScholarPubMed
Konstabel, KLönnqvist, J.-E.Walkowitz, GKonstabel, KVerkasalo, Met al.The ‘Short Five’ (S5): measuring personality traits using comprehensive single items Eur J Pers 2012; 26(1): 13–29CrossRefGoogle Scholar
Fraley, RCWaller, NGBrennan, KAAn item response theory analysis of self-report measures of adult attachment. J Pers Soc Psychol 2000; 78: 350–365CrossRefGoogle ScholarPubMed
Schwarzer, RJerusalem, MGeneralized Self-Efficacy scaleWeinman, JWright, SJohnston, MMeasures in health psychology: A user’s portfolio. Causal and control beliefs 1995 Windsor UK35–37Google Scholar
Zanarini, MCVujanovic, AAParachini, EABoulanger, JLFrankenburg, FRHennen, JA screening measure for BPD: the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD). J Pers Disord 2003; 17(6): 568–573CrossRefGoogle Scholar
Patterson, PSkeate, ASchultze-Lutter, FGraf von Reventlow, HWieneke, ARuhrmann, Set al. The Trauma and Distress Scale. Birmingham, UK:University of Birmingham 2002Google Scholar
Luutonen, STikka, MKarlsson, HSalokangas, RKChildhood trauma and distress experiences associate with psychotic symptoms in patients attending primary and psychiatric outpatient care. Results of the RADEP study. Eur Psychiatry 2013; 28(3): 154–160CrossRefGoogle ScholarPubMed
IBM SPSS Statistics for Windows, Version 22.0. Released 2013 2013 IBM Corp Armonk, NYGoogle Scholar
Norman, SBCampbell-Sills, LHitchcock, CASullivan, SRochlin, AWilkins, KCet al.Psychometrics of a brief measure of anxiety to detect severity and impairment: The overall anxiety severity and impairment scale (OASIS). J Psychiatr Res 2011; 45(2): 262–268CrossRefGoogle Scholar
Mantere, OSuominen, KLeppämäki, SValtonen, HArvilommi, PIsometsä, EThe clinical characteristics of DSM-IV bipolar I and II disorders: baseline findings from the Jorvi Bipolar Study (JoBS). Bipolar Disord 2004; 6(5): 395–405CrossRefGoogle Scholar
Mantere, OIsometsä, EKetokivi, MKiviruusu, OSuominen, KValtonen, HMet al.A prospective latent analyses study of psychiatric comorbidity of DSM-IV bipolar I and II disorders. Bipolar Disord 2010; 12(3): 271–284CrossRefGoogle ScholarPubMed
Reddy, LFGreen, MFRizzo, SSugar, CABlanchard, JJGur, REet al.Behavioral approach and avoidance in schizophrenia: an evaluation of motivational profiles. Schizophr Res 2014; 159(1): 164–170CrossRefGoogle Scholar
Konstantakopoulos, GPloumpidis, DOulis, PPatrikelis, PSoumani, APapadimitriou, GNet al.Apathy, cognitive deficits and functional impairment in schizophrenia. Schizophr Res 2011; 133(1–3):193–198CrossRefGoogle Scholar
Hansen, CFTorgalsboen, AKRossberg, JIRomm, KLAndreassen, OABell, MDet al.Object relations, reality testing, and social withdrawal in schizophrenia and bipolar disorder. J Nerv Ment Dis 2013; 201(3): 222–225CrossRefGoogle ScholarPubMed
Foussias, GAgid, OFervaha, GRemington, GNegative symptoms of schizophrenia: clinical features, relevance to real world functioning and specificity versus other CNS disorders. Eur Neuropsychopharmacol 2014; 24(5): 693–709CrossRefGoogle ScholarPubMed
Weber, KRockstroh, BBorgelt, JAwiszus, BPopov, THoffmann, Ket al.Stress load during childhood affects psychopathology in psychiatric patients. BMC Psychiatry 8 2008 63CrossRefGoogle ScholarPubMed
McFarlane, AClark, CRBryant, RAWilliams, LMNiaura, RPaul, RHet al.The impact of early life stress on psychophysiological, personality and behavioral measures in 740 non-clinical subjects. J Integr Neurosci 2005; 4(1): 27–40CrossRefGoogle ScholarPubMed
Roy, AChildhood trauma and neuroticism as an adult: possible implication for the development of the common psychiatric disorders and suicidal behavior. Psychol Med 2002; 32(8): 1471–1474CrossRefGoogle Scholar
Grant, BFChou, SPGoldstein, RBHuang, BStinson, FSSaha, TDet al.Prevalence, correlates, disability, and comorbidity of DSM-IV borderline personality disorder: results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry 2008; 69(4): 533–545CrossRefGoogle ScholarPubMed
Gallagher, MWPayne, LAWhite, KSShear, KMWoods, SWGorman, JMet al.Mechanisms of change in cognitive behavioral therapy for panic disorder: the unique effects of self-efficacy and anxiety sensitivity. Behav Res Ther 2013; 51(11): 767–777CrossRefGoogle ScholarPubMed
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