This article is more than 5 years old. Information may no longer be current.

Nearly half of individuals with bipolar disorder also have anxiety disorders

Individuals with bipolar disorder have an increased risk for anxiety disorders, as results from a systematic review and meta-analysis indicate one out of two individuals with bipolar disorder have an anxiety disorder in their lifetime.

“Most individuals with bipolar disorder also report a range of additional problems. In individuals with bipolar disorder, comorbidity with anxiety disorders is associated with more frequent relapses of mood episodes, more severe depressive episodes, a higher prevalence of substance abuse, and an increased risk of suicide attempts. Comorbidity of bipolar disorder with anxiety disorders is also associated with impaired role functioning and a reduced quality of life,” study researcher Barbara Pavlova, PhD, of the Nova Scotia Health Authority in Halifax, Canada, and colleagues wrote in Lancet Psychiatry.

Barbara Pavlova

To determine the lifetime prevalence of anxiety disorders among individuals with bipolar disorder, researchers analyzed data from 40 studies, yielding a study cohort of 14,914 individuals from North America, Europe, Australia, South America and Asia.

Overall, the lifetime prevalence of anxiety disorders among adults with bipolar disorder was 45% (95% CI, 40-51).

Analysis of five studies directly comparing 1,378 adults with bipolar disorder and 56,812 population controls indicated those with bipolar disorder had a threefold increased risk for anxiety disorders (RR = 3.22; 95% CI, 2.41-4.29; P < .0001).

Thirteen studies that included 4,270 individuals with bipolar I disorder and 1,939 with bipolar II disorder showed no difference in lifetime prevalence of anxiety disorders between the two groups (RR = 1.07; 95% CI, 0.96-1.2; P < .223).

According to researchers, there was significant heterogeneity among studies included in analyses that was not accounted for by reported differences in study characteristics.

“The finding that nearly half of individuals with bipolar disorder also suffer from anxiety disorders brings home a key message for planning of clinical services. Comorbid anxiety disorders increase the likelihood and degree of adverse outcomes in people with bipolar disorder, including time spent unwell, suicidal behavior, drug or alcohol misuse, and impaired functioning,” Pavlova and colleagues wrote. “Anxiety disorders can be treated effectively with antidepressants or cognitive behavioral therapy. Because the use of antidepressants in people with bipolar disorder is problematic, psychological treatment might need to be considered and made available for patients with comorbid bipolar disorder and anxiety.” – by Amanda Oldt

Disclosure: Pavlova reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.