Anxiety disorders and bipolar disorder: a review.
BACKGROUND
Epidemiological, clinical and familial studies indicate that anxiety disorders (ADs) are highly comorbid in persons with bipolar disorder (BPD). The phenomenological overlap between ADs and BPD is reported more frequently in individuals with female predominant bipolar presentations (e.g., bipolar II disorder). Anxiety comorbidity in the BPD population poses a serious hazard. For example, it is associated with an intensification of symptoms, non-recovery, substance use comorbidity and harmful dysfunction (e.g., suicidality).


OBJECTIVE
The evidentiary base informing treatment decisions for the anxious bipolar patient is woefully inadequate. Several expert consensus and evidence-based treatment guidelines for BPD suggest various treatment avenues, although these have been insufficiently studied. The encompassing aim of this paper is to synthesize extant studies reporting on the co-occurrence of AD and BPD. Taken together, a compelling basis emerges for prioritizing the identification and management of anxiety symptomatology in the BPD population.
McIntyre
Roger S
RS
Department of Psychiatry and Pharmacology, University Health Network, University of Toronto, 399 Bathurst Street, Toronto, Ontario, Canada. roger.mcintyre@uhn.on.ca
Soczynska
Joanna K
JK
Bottas
Alexandra
A
Bordbar
Kamran
K
Konarski
Jakub Z
JZ
Kennedy
Sidney H
SH
D001008:Anxiety Disorders / Q000453:epidemiology* / Q000523:psychology*; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000523:psychology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence