title: Anxiety as a marker of severity in acute mania.
abstract: OBJECTIVE
  Anxiety has scarcely been studied in acute mania. The aim of this study was to assess anxiety symptoms during manic episodes and their impact on clinical outcomes.
  
  
  METHODS
  Observational, cross-sectional multicentre study. Anxiety was measured using the Hamilton Anxiety Rating Scale (HARS). Bivariate and multiple linear regression analyses were performed using the HARS score as the dependent variable.
  
  
  RESULTS
  Two hundred and forty-two patients admitted with a diagnosis of acute manic episode according to DSM-IV TR criteria and a Young Mania Rating Scale>20 were analysed. Mean age was 43 years (SD=11.9) and 57% were women. Forty-six per cent of patients (n=104) presented moderate to severe anxiety symptoms (HARS score>14). Anxiety was significantly associated with severity of manic symptoms (P<0.0001). Patients with anxiety had 20% longer hospitalizations (mean 21 days, CI95% 19.7-23.7).
  
  
  CONCLUSIONS
  An association of anxiety symptoms with greater severity in acute mania was demonstrated. The close relationship between anxiety and manic symptoms highlights the need for greater clinical attention to anxiety in this population. Further studies are necessary to determine whether effective treatment of anxiety symptoms could improve clinical and care outcomes.
authors.affiliation: Hospital Santiago Apóstol, University of the Basque Country, CIBERSAM, ENBREC, Vitoria, Álava, Spain. anamaria.gonzalez-pintoarrillaga@osa-kidetza.net
authors.forename: A
authors.initials: A
authors.lastname: González-Pinto
authors.forename: J
authors.initials: J
authors.lastname: Galán
authors.forename: M
authors.initials: M
authors.lastname: Martín-Carrasco
authors.forename: J
authors.initials: J
authors.lastname: Ballesteros
authors.forename: J
authors.initials: J
authors.lastname: Maurino
authors.forename: E
authors.initials: E
authors.lastname: Vieta
mesh_terms: D000208:Acute Disease; D000328:Adult; D001007:Anxiety / Q000453:epidemiology* / Q000523:psychology; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012720:Severity of Illness Index