Our results suggest a high rate of lifetime concurrent anxiety disorders in bipolar disorder .
The diagnostic issues at the interface are particularly difficult because of the substantial symptom overlap .
BACKGROUND Bipolar affective disorder has a high rate of comorbidity with a multitude of psychiatric disorders and medical conditions .
Among all the potential comorbidities , co-existing anxiety disorders st and out due to their high prevalence .
AIMS To determine the lifetime prevalence of comorbid anxiety disorders in bipolar affective disorder under the care of psychiatric services through systematic review and meta- analysis .
Two-year outcomes for interpersonal and social rhythm therapy in individuals with bipolar I disorder.
CONTEXT Numerous studies have pointed to the failure of prophylaxis with pharmacotherapy alone in the treatment of bipolar I disorder . Recent investigations have demonstrated benefits from the addition of psychoeducation or psychotherapy to pharmacotherapy in this population . OBJECTIVE To compare 2 psychosocial interventions : interpersonal and social rhythm therapy ( IPSRT ) and an intensive clinical management ( ICM ) approach in the treatment of bipolar I disorder . DESIGN R and omized controlled trial involving 4 treatment strategies : acute and maintenance IPSRT ( IPSRT/IPSRT ) , acute and maintenance ICM ( ICM/ICM ) , acute IPSRT followed by maintenance ICM ( IPSRT/ICM ) , or acute ICM followed by maintenance IPSRT ( ICM/IPSRT ) . The preventive maintenance phase lasted 2 years . SETTING Research clinic in a university medical center . PARTICIPANTS One hundred seventy-five acutely ill individuals with bipolar I disorder recruited from inpatient and outpatient setting s , clinical referral , public presentations about bipolar disorder , and other public information activities . INTERVENTIONS Interpersonal and social rhythm therapy , an adaptation of Klerman and Weissman 's interpersonal psychotherapy to which a social rhythm regulation component has been added , and ICM . MAIN OUTCOME MEASURES Time to stabilization in the acute phase and time to recurrence in the maintenance phase . RESULTS We observed no difference between the treatment strategies in time to stabilization . After controlling for covariates of survival time , we found that participants assigned to IPSRT in the acute treatment phase survived longer without a new affective episode ( P = .01 ) , irrespective of maintenance treatment assignment . Participants in the IPSRT group had higher regularity of social rhythms at the end of acute treatment ( P<.001 ) . Ability to increase regularity of social rhythms during acute treatment was associated with reduced likelihood of recurrence during the maintenance phase ( P = .05 ) . CONCLUSION Interpersonal and social rhythm therapy appears to add to the clinical armamentarium for the management of bipolar I disorder , particularly with respect to prophylaxis of new episodes
Our results suggest a high rate of lifetime concurrent anxiety disorders in bipolar disorder .
The diagnostic issues at the interface are particularly difficult because of the substantial symptom overlap .
BACKGROUND Bipolar affective disorder has a high rate of comorbidity with a multitude of psychiatric disorders and medical conditions .
Among all the potential comorbidities , co-existing anxiety disorders st and out due to their high prevalence .
AIMS To determine the lifetime prevalence of comorbid anxiety disorders in bipolar affective disorder under the care of psychiatric services through systematic review and meta- analysis .