Differences in Axis I and II Comorbidity Between Bipolar I and II Disorders and Major Depressive Disorder.
J Clin Psychiatry 2006;67(4):584-593
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Objective: To obtain a comprehensive view
of differences in current comorbidity between bipolar I and II disorders (BD) and
(unipolar) major depressive disorder (MDD), and Axis I and II comorbidity in BD in secondary-care
Method: The psychiatric comorbidity of
90 bipolar I and 101 bipolar II patients from the Jorvi Bipolar Study and 269 MDD patients
from the Vantaa Depression Study were compared. We used DSM-IV criteria assessed by semistructured interviews. Patients were inpatients
and outpatients from secondary-care psychiatric
units. Comparable information was collected on
clinical history, index episode, symptom status, and
Results: Bipolar disorder and MDD
differed in prevalences of current comorbid
disorders, MDD patients having significantly more Axis
I comorbidity (69.1% vs. 57.1%), specifically anxiety disorders (56.5% vs. 44.5%) and cluster
A (19.0% vs. 9.9%) and C (31.6% vs. 23.0%)
personality disorders. In contrast, BD had more single cluster B personality disorders (30.9%
vs. 24.6%). Bipolar I and bipolar II were similar
in current overall comorbidity, but the prevalence
of comorbidity was strongly associated with the current illness phase.
Conclusions: Major depressive disorder
and BD have somewhat different patterns in the
prevalences of comorbid disorders at the time of
an illness episode, with differences particularly
in the prevalences of anxiety and personality
disorders. Current illness phase explains differences
in psychiatric comorbidity of BD patients better than type of disorder.