Comorbid Anxiety Disorders Found in Nearly Half of Bipolar Disorder Patients

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Nearly half of all individuals with bipolar disorder will also develop a comorbid anxiety disorder in their lifetime, according to the findings of a systematic review and meta-analysis published in The Lancet Psychiatry.

AnxietyThe finding “brings home a key message for planning of clinical services”, wrote Barbara Pavlova and fellow researchers from Dalhousie University in Canada.

“Comorbid anxiety disorders increase the likelihood and degree of adverse outcomes in people with bipolar disorder, including time spent unwell, suicidal behaviour, drug or alcohol misuse, and impaired functioning.”

These findings lead the team to suggest routine assessment and treatment of anxiety in people presenting with bipolar disorder, however, they also say the treatment of comorbid anxiety has been under-researched.

For the study, the researchers reviewed 40 eligible studies, including 29 clinical studies, seven community samples, and four mixed samples which, including 14,914 individuals with an average age of 43.2 years.

The team found the lifetime prevalence of comorbid anxiety disorders among individuals with bipolar disorder across all studies was 45%, however, the rates varied between 8% and 88% with a significant heterogeneity between studies.

The most commonly identified forms of anxiety disorder were generalized anxiety disorder (20%), social phobia (20%), panic disorder (19%), and post-traumatic stress disorder (17%).

The researchers also noted there was no significant difference in findings between individuals with bipolar I or II disorder.

According to the report, rates of comorbid anxiety were increased three-fold compared with control individuals without bipolar disorder, according to data from five of the studies including 1,378 people with bipolar disorder and 56,812 individuals without the condition.

The researchers say there are several potential causes for the heightened risk of bipolar disorder, such as childhood trauma, low self-esteem and common genetic susceptibility. However, the researchers say that given the significant impact of untreated anxiety on a patient’s health and disease course, “the treatment of anxiety disorders in bipolar disorder is a crucial target.”

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