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24-04-2012 | Mental health | Article

Anxiety disorders common in bipolar patients


Free abstract

MedWire News: Anxiety disorders are highly prevalent in patients with bipolar disorder (BD) and are associated with increased mood symptoms, study results show.

The findings, published in the Journal of Psychiatric Research, emphasize the importance of early identification and diagnosis of anxiety in BD patients, say the researchers.

Regina Sala (Columbia University, New York, USA) and team studied data on 1600 patients with BD who participated in waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. The mean interval between wave 1 and 2 interviews was 36.6 months.

The participants were assessed for anxiety disorders at the wave 1 interview using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-Version for DSM-IV.

In all, 60% of the BD patients met criteria for at least one comorbid lifetime anxiety disorder, and 40% had two or more anxiety disorders.

The researchers found that BD patients with anxiety disorders were more likely than those without to have a family history of depression (odds ratio [OR]=1.44) and alcohol and drug use problems (ORs=1.56 and 1.33, respectively).

BD patients with anxiety disorders were also more likely than those without to have been exposed to childhood risk factors, such as loss of a parent (OR=1.30) and low self-esteem (OR=1.85).

During follow-up, BD patients with anxiety disorders were more likely than those without to have experienced any depressive (OR=1.39) or manic/hypomanic episodes (OR=1.83), and to have thought about (OR=1.66) or attempted suicide (OR=1.56). They also had a greater mean number of depressive (3.37 versus 2.76) and manic/hypomanic episodes (3.63 versus 2.72) than those without anxiety disorders.

In addition, BD patients with anxiety disorders were more likely to have sought treatment for depression and mania/hypomania, had significantly more emergency room visits for depression, had more trouble at work, and more financial crises than those without anxiety disorders.

Sala and team conclude: "This study showed that anxiety disorders are highly prevalent among individuals with BD and are prospectively associated with elevated BD severity and BD-related health service use."

They add that the "clinical and treatment implications of these epidemiological findings and the additional contribution on previous clinical research in this field support that early identification and accurate diagnosis are warranted. Further studies examining specific interventions for anxiety in individuals with BD are needed."

MedWire ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Mark Cowen

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