Associations between severity of anxiety and clinical and biological features of major affective disorders

• Published in: Psychiatry research 2018-02, Vol.260, p.17-23
• Main Authors: Cavicchioli, Fernanda Liboni, Maes, Michael, Roomruangwong, Chutima, Bonifacio, Kamila Landucci, Barbosa, Decio Sabbatini, Anderson, George, Vargas, Heber Odebrecht, Nunes, Sandra Odebrecht Vargas
• Format: Article
• Language: English
• Subjects: Anxiety disorders; Bipolar disorder; Comorbidity; Depressive disorder; HDL-cholesterol; Lithium; Metabolic syndrome
• ISSN: 0165-1781; 1872-7123
• DOI: 10.1016/j.psychres.2017.11.024

Patients with major affective disorders (MAFD) with comorbid anxiety show a greater functional impairment than those without anxiety. The aim of this study is to delineate the associations between severity of anxiety in MAFD, namely bipolar disorder (BD) and major depression (MDD), and MAFD characteristics and serum high-density lipoprotein (HDL)-cholesterol levels. Recruited were 82 participants with anxiety disoders and 83 without anxiety disoders, including 101 MAFD patients and 51 healthy controls. We used the Hamilton Anxiety Rating Scale (HAM-A) to measure severity of anxiety and made the diagnoses of posttraumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), panic disorder (PD), generalized anxiety disorder (GAD) and phobias. The HAM-A score is significantly predicted by higher number of depressive episodes, GAD and phobias, childhood trauma, tobacco use disorder, metabolic syndrome and lowered HDL-cholesterol. Increased HAM-A scores are, independently from severity of depression, associated with lowered quality of life, increased disabilities and suicidal ideation. Lithium treatment significantly lowers HAM-A scores. It is concluded that severity of anxiety significantly worsens the phenomenology of MAFD. Therefore, treatments of MAFD should target increased severity of anxiety and its risk factors including low HDL-cholesterol, metabolic syndrome, childhood trauma and tobacco use disorder. •In major affective disorders (MAFD), childhood trauma and number of prior depressive episodes is associated with anxiety severity.•In MAFD, severity of anxiety is predicted by tobacco use disorder, metabolic syndrome and lowered HDL-cholesterol.•In MAFD, severity of anxiety is associated with suicidal ideation, and lowered quality of life and more disabilities.•In MAFD, treatment with lithium may lower severity of anxiety.