Anxiety and depression are common among individuals with bipolar spectrum disorders (BSDs), with anxiety being a risk factor for depression and vice versa. While the harmful effects of these symptoms are well recognized, their temporal dynamics have not been fully tested. To address this gap, our study investigated bidirectional relationships between anxiety and depression in individuals with BSDs using data from the Prechter Longitudinal Study of Bipolar Disorder, collected over an average of 11 years. We included 651 participants with various BSD subtypes (BD I, BD II, BD not otherwise specified, and schizoaffective bipolar type), with at least 5 years' data for adequate statistical power in detecting temporal dynamics. Bimonthly measurements of anxiety and depression were analyzed using dynamic structural equation modeling. Beyond assessing autoregressive and cross-lagged effects, this study also investigated whether temporal dynamics differed based on demographic characteristics and the use of psychiatric medication. Our findings revealed that individuals with BSDs experienced significant fluctuations in anxiety and depression over time. In addition, we found significant autoregressive and cross-lagged effects of anxiety and depression. Comparison of the cross-lagged effects demonstrated that anxiety had a greater effect on subsequent depression than vice versa. Age and marital status impacted cross-lagged and autoregressive effects. Specifically, older participants had stronger temporal associations between depression and subsequent anxiety, while widowed participants exhibited a heightened impact of depression on subsequent depression. These results underscore the importance of early identification and integrative interventions aimed at addressing both anxiety and depression to mitigate subsequent symptoms in BSDs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

中文翻译：

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双相情感障碍中焦虑和抑郁之间的纵向动态。


焦虑和抑郁在双相谱系障碍 (BSD) 患者中很常见，焦虑是抑郁的危险因素，反之亦然。虽然这些症状的有害影响已得到充分认识，但其时间动态尚未得到充分测试。为了解决这一差距，我们的研究利用平均 11 年收集的 Prechter 双相情感障碍纵向研究数据，调查了 BSD 患者焦虑和抑郁之间的双向关系。我们纳入了 651 名具有各种 BSD 亚型（BD I、BD II、未另行指定的 BD 和分裂情感双相型）的参与者，他们拥有至少 5 年的数据，在检测时间动态方面具有足够的统计能力。使用动态结构方程模型分析每两个月一次的焦虑和抑郁测量结果。除了评估自回归和交叉滞后效应之外，这项研究还调查了时间动态是否因人口特征和精神药物的使用而有所不同。我们的研究结果显示，随着时间的推移，患有 BSD 的人的焦虑和抑郁程度会出现显着波动。此外，我们发现焦虑和抑郁具有显着的自回归和交叉滞后效应。交叉滞后效应的比较表明，焦虑对随后的抑郁症的影响大于反之亦然。年龄和婚姻状况影响交叉滞后和自回归效应。具体来说，年龄较大的参与者在抑郁和随后的焦虑之间具有更强的时间关联，而丧偶的参与者表现出抑郁对随后的抑郁的影响更大。 这些结果强调了早期识别和综合干预措施的重要性，旨在解决焦虑和抑郁问题，以减轻 BSD 的后续症状。 （PsycInfo 数据库记录 (c) 2024 APA，保留所有权利）。