Korean Journal of Biological Psychiatry (생물정신의학)

The Korean Society of Biological Psychiatry (대한생물정신의학회)
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Anxiety Hastened Depressive Recurrence in Bipolar Disorder : An Interim Analysis of Prospective Follow-Up Study

양극성 장애 환자에서 불안이 질병 경과에 미치는 영향 : 전향적 추적관찰에 대한 중간분석

  • Kim, Soojeong (Department of Psychiatry, National Center for Mental Health) ;
  • Kim, So Jeong (Mood Disorders Clinic, National Center for Mental Health) ;
  • Song, Hye Hyun (Department of Psychiatry, National Center for Mental Health) ;
  • Lee, Wonhye (Clinical Psychology, National Center for Mental Health) ;
  • Chon, Myong-Wuk (Department of Psychiatry, National Center for Mental Health) ;
  • Nam, Yoon Young (Department of Psychiatry, National Center for Mental Health) ;
  • Park, Dong Yeon (Mood Disorders Clinic, National Center for Mental Health)
  • 김수정 (국립정신건강센터 성인정신과) ;
  • 김소정 (국립정신건강센터 기분장애클리닉) ;
  • 송혜현 (국립정신건강센터 성인정신과) ;
  • 이원혜 (국립정신건강센터 임상심리과) ;
  • 전명욱 (국립정신건강센터 성인정신과) ;
  • 남윤영 (국립정신건강센터 성인정신과) ;
  • 박동연 (국립정신건강센터 기분장애클리닉)
  • Received : 2021.01.29
  • Accepted : 2021.03.04
  • Published : 2021.04.30
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Abstract

Objectives Despite growing attention to anxiety in bipolar disorder (BD), little research has assessed anxiety symptoms in the course of BD. The current prospective follow-up study examines the influence of subjectively and objectively measured anxiety symptoms on the course of BD. Methods A total of 49 patients with BD were followed-up prospectively for average of one year at an average of four months interval. The Korean version of the Beck Anxiety Inventory (K-BAI), the Hamilton Anxiety Rating Scale, heart rate variability (HRV) were used to measure anxiety subjectively, objectively and physiologically. Participants were divided into high and low anxiety groups based on their K-BAI scores. Kaplan-Meier survival analysis was performed to compare the recurrence of mood episode, suicide attempt, emergency room visit, and psychiatric hospitalization between two groups. Mediators were investigated with Cox proportional hazards models. Results Compared to the low anxiety group, the high anxiety group reported significantly higher impulsiveness (p = 0.016) and lower high frequency component on HRV (p = 0.007) after controlling for severity of BD. Regarding survival analysis, the high anxiety group showed hastened depressive episode recurrence (p = 0.048) and suicidal ideation was the mediator of the hazard ratio (HR) 1.089 (p = 0.029) in the Cox model. Moreover, the high anxiety group showed a tendency of accelerated suicide attempt (p = 0.12) and impulsivity was the risk factor of suicide attempt (HR = 1.089, p = 0.036). Conclusions This interim analysis of prospective study suggests that high anxiety level in BD may anticipate unfavorable course. Further studies are needed to understand the multifactorial mechanism of anxious bipolar patients.

Keywords

Acknowledgement

본 논문은 2020년도 국립정신건강센터 임상연구사업(과제번호 2020-12)의 지원을 받아 수행된 연구임.

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