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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 26, 2026; 14(3): 114691
Published online Jan 26, 2026. doi: 10.12998/wjcc.v14.i3.114691
Published online Jan 26, 2026. doi: 10.12998/wjcc.v14.i3.114691
Early intervention in anxiety disorder patients with clinical high-risk factors for bipolar disorder: A randomized controlled trial
Hong Wang, Department of Psychiatry, Huzhou Third Municipal Hospital Affiliated Hospital of Wenzhou Medical University, Huzhou 313000, Zhejiang Province, China
Shi-Liang Wang, Li-Lei Lei, Lei Zeng, Min-Cai Qian, Department of Psychosomatic Medicine, Huzhou Third Municipal Hospital Affiliated Hospital of Wenzhou Medical University, Huzhou 313000, Zhejiang Province, China
Chen-Jie Ge, Division of Quality Management, Huzhou Third Municipal Hospital Affiliated Hospital of Wenzhou Medical University, Huzhou 313000, Zhejiang Province, China
Author contributions: Wang H and Wang SL contributed to methodology; Wang H contributed to investigation, formal analysis, writing of the original draft, and project administration; Wang SL and Qian MC contributed to manuscript review and editing; Ge CJ, Lei LL, and Zeng L contributed to investigation, resources, and data curation; Qian MC contributed to conceptualization, supervision, and fund acquisition.
Supported by Huzhou Science and Technology Programmer, No. 2020GZ42.
Institutional review board statement: The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Ethics Committee of Huzhou Third Municipal Hospital.
Clinical trial registration statement: This trial was registered at the Chinese Clinical Trial Registry (www.medicalresearch.org.cn) on January 19, 2021 (No. MR-33-21-004208).
Informed consent statement: Written informed consent was obtained from all subjects involved in the study, and from their legal guardians when applicable, prior to their enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: The data that support the findings of this study are not publicly available due to restrictions from the ethics committee and to protect patient privacy. However, deidentified data are available from the corresponding author upon reasonable request and with permission from the institutional review board.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Min-Cai Qian, MD, Chief Physician, Department of Psychosomatic Medicine, Huzhou Third Municipal Hospital Affiliated Hospital of Wenzhou Medical University, No. 2088 East Campsis Road, Wuxing District, Huzhou 313000, Zhejiang Province, China. 1311956613@qq.com
Received: September 26, 2025
Revised: November 18, 2025
Accepted: January 8, 2026
Published online: January 26, 2026
Processing time: 118 Days and 21.9 Hours
Revised: November 18, 2025
Accepted: January 8, 2026
Published online: January 26, 2026
Processing time: 118 Days and 21.9 Hours
Core Tip
Core Tip: This randomized controlled trial investigated early intervention in 66 antidepressant-naive adults with anxiety disorders who also presented clinical high-risk factors for bipolar disorder. The combination of sertraline and lithium demonstrated a significantly faster reduction in anxiety symptoms within the first four weeks compared to sertraline monotherapy, with comparable safety profiles. These preliminary findings suggest that early adjunctive mood stabilization may accelerate response and potentially mitigate the risk of manic switch in this clinically complex and high-risk population, warranting further investigation in larger trials.