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Co-morbid anxiety disorders in bipolar disorder and major depression: familial aggregation and clinical characteristics of co-morbid panic disorder, social phobia, specific phobia and obsessive-compulsive disorder

Published online by Cambridge University Press:  21 November 2011

F. S. Goes ,
M. G. McCusker ,
O. J. Bienvenu ,
D. F. MacKinnon ,
F. M. Mondimore ,
B. Schweizer ,
J. R. DePaulo Jr.  and
J. B. Potash
F. S. Goes*
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
M. G. McCusker
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
O. J. Bienvenu
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
D. F. MacKinnon
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
F. M. Mondimore
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
B. Schweizer
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
J. R. DePaulo Jr.
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
J. B. Potash
Affiliation:
Department of Psychiatry, University of Iowa, Iowa City, IA, USA
*
*Address for correspondence: F. S. Goes, M.D., Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Meyer 4-119, 600 N. Wolfe Street, Baltimore, MD, 21287, USA. (Email: fgoes1@jhmi.edu)
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Abstract

Background

Co-morbidity of mood and anxiety disorders is common and often associated with greater illness severity. This study investigates clinical correlates and familiality of four anxiety disorders in a large sample of bipolar disorder (BP) and major depressive disorder (MDD) pedigrees.

Method

The sample comprised 566 BP families with 1416 affected subjects and 675 MDD families with 1726 affected subjects. Clinical characteristics and familiality of panic disorder, social phobia, specific phobia and obsessive-compulsive disorder (OCD) were examined in BP and MDD pedigrees with multivariate modeling using generalized estimating equations.

Results

Co-morbidity between mood and anxiety disorders was associated with several markers of clinical severity, including earlier age of onset, greater number of depressive episodes and higher prevalence of attempted suicide, when compared with mood disorder without co-morbid anxiety. Familial aggregation was found with co-morbid panic and OCD in both BP and MDD pedigrees. Specific phobia showed familial aggregation in both MDD and BP families, although the findings in BP were just short of statistical significance after adjusting for other anxiety co-morbidities. We found no evidence for familiality of social phobia.

Conclusions

Our findings suggest that co-morbidity of MDD and BP with specific anxiety disorders (OCD, panic disorder and specific phobia) is at least partly due to familial factors, which may be of relevance to both phenotypic and genetic studies of co-morbidity.

Keywords

Anxiety disordersfamilialmood disordersobsessive-compulsive disorderpanicphobia
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 7 , July 2012 , pp. 1449 - 1459
Copyright
Copyright © Cambridge University Press 2011

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Supplementary material: File

Goes Supplementary Table 1

Supplementary Table S1. Familial aggregation of comorbid anxiety disorders in all available relatives in the bipolar disorder sample

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