title: Comorbid anxiety disorders in Canadians with bipolar disorder: clinical characteristics and service use.
abstract: OBJECTIVE
  To examine the impact of anxiety disorders comorbid to bipolar disorder (BD) in a large, nationally representative sample, to describe the sociodemographic and clinical profiles of Canadians living with BD and with or without comorbid anxiety disorders, to identify the characteristics uniquely associated with comorbid anxiety, and to examine treatment patterns.
  
  
  METHODS
  We analyzed data from the Canadian Community Health Survey: Mental Health and Well-Being, conducted among 38 492 Canadians. People meeting the criteria for BD (n = 808) were compared based on the presence or absence of an assessed anxiety disorder (that is, social phobia, panic disorder, and agoraphobia).
  
  
  RESULTS
  People with BD and a comorbid anxiety disorder fare worse in terms of BD relapses, suicidality, and sleep disturbance, and are more likely to be taking psychiatric medication. They have more impairment in their work and social functioning and rate their health and life satisfaction lower. Despite the greater severity, they are not receiving additional psychological treatment, they feel they are not receiving the treatment they need, and they report more barriers to treatment.
  
  
  CONCLUSIONS
  This study confirms the critical impact of comorbid anxiety on the course of BD in a large, nationally representative sample and reveals that the psychological treatment needs of this population are not being met. Clinical and research implications are discussed.
authors.affiliation: University Health Network, Toronto, Ontario, Canada.
authors.forename: Lisa D
authors.initials: LD
authors.lastname: Hawke
authors.forename: Martin D
authors.initials: MD
authors.lastname: Provencher
authors.forename: Sagar V
authors.initials: SV
authors.lastname: Parikh
authors.forename: Brandon
authors.initials: B
authors.lastname: Zagorski
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000453:epidemiology*; D001714:Bipolar Disorder / Q000453:epidemiology*; D002170:Canada / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D012720:Severity of Illness Index; D055815:Young Adult
keywords: anxiety disorders; bipolar disorder; comorbidity