Comparison of comorbid anxiety disorder frequencies determined by clinical follow-up vs. structured clinical interview in patients with bipolar disorder

AIM: Anxiety Disorders (ADs), when comorbid with Bipolar Disorder (BD), are associated with reduced quality of life, more hospitalizations, worse treatment response, and higher rates of suicidal attempts in BD patients. The aims of our study were: (1) to detect rates of AD [panic disorder (PD), agoraphobia, specific phobia (SP), generalized anxiety disorder (GAD), social anxiety disorder (SAD)], obsessive-compulsive disorder (OCD) and post traumatic stress disorder (PTSD) comorbidity in patients followed at Mood Disorders Unit (MDU) and general outpatient unit (GOU) of Istanbul Medical Faculty's Psychiatry Department, (2) to compare AD comorbidity rates found by structured interview with the rates recorded in medical files of clinical follow-up and, (3) to compare the rates of missed diagnosis of ADs in MDU and GOU. METHODS: 60 BD patients were included in the study. Patients were evaluated by using Hamilton Depression Rating Scale (HDRS), Young Mania Rating Scale (YMRS) and interviewed with the Clinician Version of Structured Clinical Interview for DSM-5 Disorders (SCID-5-CV). DSM-5 diagnostic criteria for SP were questioned in patients who answered positively to the screening question of SCID-5-CV for SP. RESULTS: The rate of any AD comorbidity in BD was 41,7%. Current rates of ADs were; SP 25%, GAD 3,3%, SAD 5%, OCD 8,3% and PTSD 1,7%. Lifetime rate of PTSD was 13,3% and PD was 3,3%. The rates of SP and lifetime PTSD detected by the structured interview was significantly higher than the rates detected by clinical interview. Rates of missed AD diagnosis were similar in two units. CONCLUSION: AD comorbidity is frequently missed in patients with BD. This was also true even in a specialized unit for BD. It is important to screen BD patients with structured interviews for AD comorbidity.