Determining the relationship between bipolar disorder and anxiety disorders

Objective: The aim of this study is to determine the rate of comorbidity of anxiety disorders in patients with bipolar disorder, and to investigate the associations of comorbid anxiety disorders with several sociodemographic and clinical variables. Method: The study included 200 patients who were admitted to the Adnan Menderes University Medical Faculty Hospital Psychiatric Outpatient Clinic or who received inpatient treatment at the psychiatric ward and between the ages of 18 and 65 who received bipolar disorder type I or type II diagnosis according to DSM-IV diagnostic criteria. All participants were applied Structured Clinical Interview scale for DSM-IV axis diagnoses (SCID-I), Beck Depression Inventory and Young Mania Rating Scale. Results: The prevalence of any lifetime and current anxiety disorder for the entire sample was 43.5% and 32.5%, respectively. We have found that the rate of bipolar disorder patients with more than one additional lifetime and current diagnoses of any anxiety disorders were 6.5% and 11.5%, respectively. Current comorbidity rates were 14% for social anxiety disorder, 8.5% for obsessive compulsive disorder, 7% for generalized anxiety disorder, 5% for spesific phobia, 2.5% for posttraumatic stress disorder, 2.5% for panic disorder. Lifetime comorbidity rates were 16% for social anxiety disorder, 14% for obsessive compulsive disorder, 13.5% for generalized anxiety disorder, 5% for spesific phobia, 4.5% for panic disorder and 3% for posttraumatic stress disorder. The previous history (p=0.039) and mean number of suicidal attempts (p=0.022), mean number of suicide attempts during the depression period (p=0.005), rate of suicidal attempt with drug (p=0.043) and incision (p=0.015) and, mean Beck Depression Inventory scores were found to be higher in bipolar disorder patients with current comorbid anxiety disorders (p<0.0001). The mean number of suicide attempts (p=0.031), mean number of suicide attempts during the depression period (p=0.006), the rate of suicide attempts with incision (p=0.046), and the mean Beck Depression Inventory scores (p<0.0001) were significantly higher in bipolar disorder patients with lifetime comorbid anxiety disorders. In bipolar disorder patients with a lifetime comorbid diagnosis of social anxiety disorder, the previous history of suicidal attempts (p=0.035), mean number of suicidal attempt (p=0.033), mean number of suicide attempts during the depression period (p=0.001), rate of suicidal attempt with drugs (p=0.029), the mean scores of Beck Depression Inventory were sigficantly higher than in bipolar disorder patients without any comorbidity. Conclusion: Comorbidity of any anxiety disorders in patients with bipolar disorder is a frequent condition, and especially is characterized with increasing suicide attempts. Additional diagnoses of anxiety disorders, particularly social anxiety disorder seem to be associated with several sociodemographic clinical variables. Key Words: Bipolar, Anxiety, Comorbidity