Anxiety Features In Bipolar ? And ? Disorders

BackgroundBipolar disorder has two major types,i.e.,bipolar ? and ? disorders,which are devastating and characterized by recurrent episodes of mania/hypomania and depression,with frequent relapse,lingering residual symptoms,impaired cognition,and diminished wellbeing.There were no objective clinical and biological biomarkers to differentiate bipolar? and ? disorders up to date.Literature tell that anxiety trait is a heritable phenotype of bipolar disorder,and health anxiety and body image concerns are important anxiety symptoms associated with self-cognition.Therefore,could their performance characterizes bipolar ? and? disorders,and display relationships with affective states and personality traits?AimsWe are aiming to explore the differences of bipolar ? and bipolar ? disorders from the views of illness anxiety and body image concerns,to look for the effects of affective states and personality traits on the illness attitude and body image concerns,and to establish the related personality disorder functioning styles which predicting illness anxiety and body image concerns with affective states as mediating factors.MethodsWe have invited 87 patients with bipolar ? disorder,92 bipolar ? disorder and 129 healthy volunteers to undergo the tests of the Illness Attitude Scales(IAS),the Parker Personality Measure(PERM),and the measurements for concurrent affective states,namely the Plutchik-van Praag Depression Inventory(PVP),the Mood Disorder Questionnaire(MDQ),and the Hypomania Checklist-32,(HCL-32).We also invited 89 patients with bipolar? disorder,91 bipolar ? disorder patients,and 159 healthy volunteers to undergo the Body Image Concern Scale as well as PVP,MDQ,HCL-32,and PERM.Results were analyzed by two-way ANOVA to detect the differences of questionnaire scale scores among three groups.Multiple linear regressions(backward method)were used to search for the relationship of personality disorder functioning styles/affective states predicting IAS or BICS scores.ResultsAs for the IAS,patients with two bipolar disorder types scored significantly higher on Symptom Effect and Treatment Seeking,and patients with bipolar ? disorder scored higher on Patho-thanatophobia and Hypochondriacal Belief.Patients with bipolar ? disorder in addition scored higher on Patho-thanatophobia than patients with bipolar ? disorder did.In controls,the Dependent style predicted Patho-thanatophobia and Symptom Effect,Schizoid with Hypochondriacal Belief;in patients with bipolar ? disorder,Narcissistic(-)with Hypochondriacal Belief,Histrionic with Patho-thanatophobia and Hypochondriacal Belief,depression with Hypochondriacal Belief,and hypomania with Symptom Effect and Hypochondriacal Belief;in patients with bipolar ? disorder,depression with Symptom Effect and Hypochondriacal Belief,mania with Symptom Effect.Moreover,the association between Paranoid and Symptom Effect was mediated by depression in bipolar ? disorder.Patients with bipolar ? disorder scored higher on all six BICS scales than controls did,and higher on five scales than bipolar ? disorder did.The depressive measure predicted four,and Dependent style predicted three BICS scales in bipolar ? disorder;and the depressive measure predicted all six BICS scales,hypomanic measure predicted one,and Avoidant style predicted one in patients with bipolar ? disorder.ConclusionBipolar disorder,especially bipolar ? type,displayed more hypochondriacal and body image concerns,which had connections with personality disorder functioning styles and concurrent affective states.These helped to differentiate bipolar I and bipolar II disorders and suggested different pathological mechanisms,clinical symptom severities and managements for the two.The implicit theory has also be enriched by the correlation of personality disorder traits,self-cognitions and affective states in bipolar disorder.