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Studies of patients with major depression have associated prominent anxiety symptoms with greater severity and persistence of depressive symptoms. More recently, these findings have been replicated in studies of bipolar disorder; high levels of anxiety or coexisting anxiety disorders in bipolar patients increase the likelihood of rapid switching and suicidal behavior, shorten euthymic periods, worsen outcomes, and delay remission from the index episode. Researchers further examined these issues in an analysis of data from a long-term surveillance study that followed 427 patients with bipolar I or II disorder for up to 20 years (average follow-up, 16 years).
Patients whose initial presentation was a depressive episode spent significantly more…