{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:48:46Z","timestamp":1787014126915,"version":"build-2736575974"},"reference-count":45,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,11,15]],"date-time":"2019-11-15T00:00:00Z","timestamp":1573776000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Early Intervention Psych"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Up to just over half of bipolar disorder (BD) patients report at least one\u2010lifetime anxiety disorder (AD). In some, anxiety represents the earliest psychiatric manifestation, prior to any mood episode. We sought to investigate prevalence of AD subtypes as first psychiatric manifestations and AD's relations with duration of untreated illness (DUI) and treatment among BD outpatients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We recruited patients referred to the Centre for the Treatment of Depressive Disorders in Milan, diagnosed with BD\u2010I, BD\u2010II, BD not otherwise specified (BD\u2010NOS) and cyclothymia according to Diagnostic and Statistical Manual fourth edition\u2010text revision criteria. Several clinical characteristics were assessed through retrospective chart review and\/or direct patient interviews. Based on presence\/absence of an AD at psychiatric onset, eligible subjects were stratified into two groups (A+ and A\u2212) and clinical features were compared between these groups and between BD subtypes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We analysed 260 BD patients (77 BD\u2010I, 122 BD\u2010II, 45 BD\u2010NOS and 16 cyclothymia). An AD was the first psychiatric manifestation in 69 patients (26.5%). BD\u2010II and BD\u2010NOS more frequently had an AD at psychiatric onset, with panic disorder being the most common AD. Among A+ vs A\u2212, age at BD onset was younger, duration of untreated BD illness (DUI) was longer, and a mood stabilizer\/antipsychotic was less often prescribed at psychiatric onset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Considering BD in its longitudinal course, over one in four BD patients presenting with an AD at psychiatric onset belatedly access adequate treatment, with subsequent prolonged DUI and prospective worse outcome compared to patients with a mood episode at psychiatric onset.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/eip.12900","type":"journal-article","created":{"date-parts":[[2019,11,16]],"date-time":"2019-11-16T01:58:12Z","timestamp":1573869492000},"page":"714-722","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Clinical features and patterns of psychopharmacological prescription in bipolar patients with vs without anxiety disorders at onset"],"prefix":"10.1111","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4677-9665","authenticated-orcid":false,"given":"Cesare","family":"Galimberti","sequence":"first","affiliation":[{"name":"Psychiatry Unit, Department of Biomedical and Clinical Sciences \u201cLuigi Sacco\u201d University of Milan  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Caricasole","sequence":"additional","affiliation":[{"name":"Psychiatry Unit, Department of Biomedical and Clinical Sciences \u201cLuigi Sacco\u201d University of Milan  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica F.","family":"Bosi","sequence":"additional","affiliation":[{"name":"Psychiatry Unit, Department of Biomedical and Clinical Sciences \u201cLuigi Sacco\u201d University of Milan  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina A.","family":"Vigan\u00f2","sequence":"additional","affiliation":[{"name":"Psychiatry Unit, Department of Biomedical and Clinical Sciences \u201cLuigi Sacco\u201d University of Milan  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terence A.","family":"Ketter","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioural Sciences Bipolar Disorders Clinic, Stanford University  California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernardo","family":"Dell'Osso","sequence":"additional","affiliation":[{"name":"Psychiatry Unit, Department of Biomedical and Clinical Sciences \u201cLuigi Sacco\u201d University of Milan  Milan Italy"},{"name":"Department of Psychiatry and Behavioural Sciences Bipolar Disorders Clinic, Stanford University  California"},{"name":"CRC \"Aldo Ravelli\" for Neurotechnology and Experimental Brain Therapeutics, University of Milan  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,11,15]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2015.04.024"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00406-009-0085-2"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1092852900016588"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-1241.2007.01450.x"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eurpsy.2007.11.004"},{"issue":"4","key":"e_1_2_8_7_1","first-page":"232","article-title":"Comorbidity of bipolar disorder and eating disorders","volume":"8","author":"Alvarez Ruiz E. 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