Comorbid Axis I disorders highly prevalent in mood disorder patients

By Mark Cowen, Senior medwireNews Reporter

More than 80% of patients with mood disorders have at least one comorbid Axis I disorder, study results show.

Furthermore, Keming Gao (Case Western Reserve University School of Medicine, Cleveland, Ohio, USA) and team report that a greater number of comorbid Axis I disorders is associated with increased mood disorder severity and suicide ideation.

"Positive correlations between baseline severity and the number of comorbidities and complex patterns of comorbidity in mood disorders underscore the importance of correct identification and proper treatment of these disorders," they comment in the Journal of Affective Disorders.

The team studied 166 patients with bipolar disorder (BD) and 113 with major depressive disorder (MDD) who were assessed for mood disorder severity and suicidal behaviour at initial presentation using the Clinical Global Impression - Severity (CGI-S) scale and the Suicide Assessment module of the Mini International Neuropsychiatric Interview (MINI), respectively.

The researchers also assessed the effectiveness of the Quick Inventory of Depression Symptomatology - 16 items-Self-Report (QIDS-16-SR) for predicting the number of Axis I comorbidities in the participants.

They found that Axis I disorders, as assessed during follow-up visits using the MINI Systematic Treatment Enhancement Program for Bipolar Disorder version 5.0.0, were highly prevalent among the study population.

Indeed, more than 80% of BD and MDD patients had at least one comorbid Axis I disorder during follow up, while a respective 20% and 10% had four or more comorbidities.

In BD patients, 74% had an anxiety disorder, 29% had a substance abuse disorder, 21% had attention deficit hyperactivity disorder, and 6% had an eating disorder. The corresponding rates in MDD patients were 76%, 14%, 8%, and 5%.

Furthermore, the number of Axis I comorbidities during follow up was positively associated with baseline mood disorder severity and the presence of suicidal ideation in both groups.

The researchers also found that a baseline QIDS-16-SR score of at least 10 had a positive predictive value of 90% in predicting at least one Axis I comorbidity in both BD and MDD patients.

Gao and team conclude: "A thorough diagnostic interview on Axis I comorbidity in patients with mood disorders should become mandatory, especially when a QIDS-16-SR score is ≥10 points."

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