title: Comorbid anxiety in bipolar disorder alters treatment and prognosis.
abstract: Mood disorders in general, and bipolar disorder in particular, are unique among the psychiatric conditions in that they are associated with extraordinarily high rates of comorbidity with a multitude of psychiatric and medical conditions. Among all the potential comorbidities, co-occurring anxiety disorders stand out due to their very high prevalence. Outcome in bipolar illness is worse in the presence of a comorbid anxiety disorder. The coexistence of an anxiety disorder presents a particularly difficult challenge in the treatment of bipolar illness since antidepressants, the mainstay of pharmacologic treatments for anxiety, may adversely alter the course of manic-depression. Identification of anxiety disorders in bipolar patients is important. The treatment plan needs to balance the potential benefit and harm of antidepressant administration.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, MedCenter One, 501 E Broadway, Louisville, KY 40202, USA. rselma01@louisville.edu
authors.forename: Rif S
authors.initials: RS
authors.lastname: El-Mallakh
authors.forename: Michael
authors.initials: M
authors.lastname: Hollifield
mesh_terms: D000293:Adolescent; D000328:Adult; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D002648:Child; D015897:Comorbidity; D006801:Humans; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000453:epidemiology; D016584:Panic Disorder / Q000175:diagnosis / Q000453:epidemiology; D010698:Phobic Disorders / Q000175:diagnosis / Q000453:epidemiology; D015995:Prevalence; D011379:Prognosis; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents