Subsyndromal anxiety: Does it affect the quality of life? A study on euthymic patients with bipolar disorder

Abstract

Background and objectivesPatients with bipolar disorder (BD) have a severely impaired quality of life (QoL), even when euthymic. The impact of subsyndromal affective symptoms and comorbid anxiety disorders has been clearly established. However, once an anxious comorbid disorder has been ruled out, no attention is paid to current anxiety. The aim was to determine whether subsyndromal anxiety impacts on current QoL in euthymic BD patients, regardless of comorbid anxiety disorders. MethodsEuthymic BD patients attending the National Institute of Psychiatry were assessed for perceived QoL and current anxiety symptoms. Presence or absence of comorbid anxiety disorders was established by the treating psychiatrist. Results60 patients, (86.7% with type I BD) with a mean age of 47.2 years (SD=11) were included. Mild to moderate symptoms of anxiety were reported and 20% of the patients had a Poor-QoL. Patients with Poor-QoL exhibited higher subsyndromal manic symptoms (Cohen d=0.83) and higher anxiety symptoms (Cohen d=1.04). Anxiety symptoms were the most important predictor for Poor-QoL in BD patients (OR=1.05). ConclusionThe presence of anxious symptoms, even in patients without a comorbid anxious disorder, impact QoL negatively in euthymic BD patients. Their assessment and effective treatment should be included in routine clinical practice.