title: The relationship between bipolar disorders, anxiety, and trauma - implications for clinical practice.
abstract: OBJECTIVE
  To assess the relationship between bipolar spectrum disorders, anxiety disorders, trauma, and personality function.
  
  
  METHODS
  A cohort of 37 diagnostically challenging bipolar spectrum patients, including both bipolar and personality disordered patients, were assessed using the Structured Combined Interview for DSM-IV to establish diagnosis of bipolarity and anxiety. Diagnoses were then quantitatively related to personality function, using the DSM-5 Level of Personality Function Scale, and to attachment, using the Relationship Questionnaire and Relationship Style Questionnaire.
  
  
  RESULTS
  Number of comorbid anxiety disorders was significantly related to both personality and attachment, but not to bipolar status. Patients with more than one anxiety disorder were significantly more likely to have an underlying disturbance of personality.
  
  
  CONCLUSIONS
  The presence of multiple anxiety disorders in bipolar spectrum patients may indicate heightened risk of an underlying personality disorder. Replication in a larger and more representative sample is needed.
authors.affiliation: CADE Clinic, Royal North Shore Hospital, Sydney, NSW, Australia sandy.kuiper@health.nsw.gov.au.
authors.forename: Sandy
authors.initials: S
authors.lastname: Kuiper
authors.affiliation: CADE Clinic, Royal North Shore Hospital, Sydney, NSW, Australia.
authors.forename: Claire
authors.initials: C
authors.lastname: McAulay
authors.affiliation: Discipline of Psychiatry, University of Sydney, Sydney, NSW, and; Westmead Psychotherapy Program for Complex Traumatic Disorders, Westmead Hospital, Sydney, NSW, Australia.
authors.forename: Loyola
authors.initials: L
authors.lastname: McLean
authors.affiliation: CADE Clinic, Royal North Shore Hospital, Sydney, NSW, and; Discipline of Psychiatry, University of Sydney, Sydney, NSW, Australia.
authors.forename: Gin
authors.initials: G
authors.lastname: Malhi
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology; D001714:Bipolar Disorder / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D010554:Personality Disorders / Q000453:epidemiology; D000067073:Psychological Trauma / Q000453:epidemiology
keywords: anxiety; bipolar disorder; personality