CNSPulse
W62

THE COMPLEX DIAGNOSTIC PROFILE OF PSYCHIATRIC OUTPATIENTS PRESENTING FOR THE TREATMENT OF BIPOLAR DEPRESSION

Mark Zimmerman — Barbara Lu1 1Brown University

2026 ASCP Annual Meeting

Objectives

To examine the prevalence of current comorbid disorders in outpatients presenting for the treatment of bipolar depression and determine the significance of comorbidity by examining whether patients want treatment to address the comorbid disorder and whether comorbidity is associated with prolonged unemployment.

Methods

One hundred thirty-one psychiatric outpatients with bipolar depression were interviewed with the Structured Clinical Interview for DSM-IV (SCID) and the borderline personality disorder section of the Structured Interview for DSM-IV Personality. At the end of each SCID module patients were asked if the symptoms of the disorder were a reason for coming for treatment. The interview also included the item from the Schedule for Affective Disorders and Schizophrenia assessing the amount of time missed from work due to psychiatric reasons during the past 5 years.

Results

Nearly 80% of the patients were diagnosed with at least 1 comorbid disorder (n=104, 79.4%), more than 60% were diagnosed with 2 or more comorbid disorders (n=82, 62.6%), and almost half were diagnosed with 3 or more disorders (n=60, 45.8%). More than two-thirds of all patients wanted their treatment to also address a comorbid disorder (n=89, 67.9%). For each anxiety disorder except specific phobia more than three-quarters of the patients with the disorder wanted treatment to address the comorbid anxiety disorder. More than 90% of the patients with attention deficit disorder desired treatment for the comorbidity. By contrast, patients were least interested in having treatment for a comorbid substance use disorder. Patients with 2 or more comorbid disorders were more than 3 times more likely to be chronically unemployed than patients who were not diagnosed with 2 or more disorders.

Conclusion

Most patients presenting for the treatment of bipolar depression have a comorbid psychiatric disorder and they usually want their treatment to also address their comorbid conditions.