title: Prevalence of current anxiety disorders in people with bipolar disorder during euthymia: a meta-analysis.
abstract: BACKGROUND
  Anxiety disorders are highly prevalent in people with bipolar disorder, but it is not clear how many have anxiety disorders even at times when they are free of major mood episodes. We aimed to establish what proportion of euthymic individuals with bipolar disorder meet diagnostic criteria for anxiety disorders.
  
  
  METHODS
  We performed a random-effects meta-analysis of prevalence rates of current DSM-III- and DSM-IV-defined anxiety disorders (panic disorder, agoraphobia, social anxiety disorder, generalized anxiety disorder, specific phobia, obsessive-compulsive disorder, post-traumatic stress disorder, and anxiety disorder not otherwise specified) in euthymic adults with bipolar disorder in studies published by 31 December 2015.
  
  
  RESULTS
  Across 10 samples with 2120 individuals with bipolar disorder, 34.7% met diagnostic criteria for one or more anxiety disorders during euthymia [95% confidence interval (CI) 23.9-45.5%]. Direct comparison of 189 euthymic individuals with bipolar disorder and 17 109 population controls across three studies showed a 4.6-fold increase (risk ratio 4.60, 95% CI 2.37-8.92, p < 0.001) in prevalence of anxiety disorders in those with bipolar disorder.
  
  
  CONCLUSIONS
  These findings suggest that anxiety disorders are common in people with bipolar disorder even when their mood is adequately controlled. Euthymic people with bipolar disorder should be routinely assessed for anxiety disorders and anxiety-focused treatment should be initiated if indicated.
authors.affiliation: Nova Scotia Health Authority,Halifax, Nova Scotia,Canada.
authors.forename: B
authors.initials: B
authors.lastname: Pavlova
authors.affiliation: Department of Psychiatry,Harvard Medical School,Boston, MA,USA.
authors.forename: R H
authors.initials: RH
authors.lastname: Perlis
authors.affiliation: Douglas Mental Health University Institute,Montréal, Québec,Canada.
authors.forename: O
authors.initials: O
authors.lastname: Mantere
authors.affiliation: Department of Psychiatry,Harvard Medical School,Boston, MA,USA.
authors.forename: C M
authors.initials: CM
authors.lastname: Sellgren
authors.affiliation: Department of Psychiatry,University of Helsinki and Helsinki University Hospital,Helsinki,Finland.
authors.forename: E
authors.initials: E
authors.lastname: Isometsä
authors.affiliation: University of New South Wales, School of Psychiatry,Sydney,Australia.
authors.forename: P B
authors.initials: PB
authors.lastname: Mitchell
authors.affiliation: Nova Scotia Health Authority,Halifax, Nova Scotia,Canada.
authors.forename: M
authors.initials: M
authors.lastname: Alda
authors.affiliation: Nova Scotia Health Authority,Halifax, Nova Scotia,Canada.
authors.forename: R
authors.initials: R
authors.lastname: Uher
mesh_terms: D001008:Anxiety Disorders / Q000453:epidemiology*; D001714:Bipolar Disorder / Q000453:epidemiology*; D015897:Comorbidity; D006801:Humans; D015995:Prevalence
keywords: Anxiety disorders; bipolar disorder; co-morbidity; euthymia; meta-analyses