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 .
Do comorbid anxiety disorders moderate the effects of psychotherapy for bipolar disorder? Results from STEP-BD.
OBJECTIVE At least 50 % of individuals with bipolar disorder have a lifetime anxiety disorder . Individuals with both bipolar disorder and a co-occurring anxiety disorder experience longer illness duration , greater illness severity , and poorer treatment response . The study explored whether comorbid lifetime anxiety in bipolar patients moderates psychotherapy treatment outcome . METHOD In the Systematic Treatment Enhancement Program r and omized controlled trial of psychotherapy for bipolar depression , participants received up to 30 sessions of intensive psychotherapy ( family-focused therapy , interpersonal and social rhythm therapy , or cognitive-behavioral therapy ) or collaborative care , a three-session comparison treatment , plus pharmacotherapy . Using the number needed to treat , we computed effect sizes to analyze the relationship between lifetime anxiety disorders and rates of recovery across treatment groups after 1 year . RESULTS A total of 269 patients ( 113 women ) with a comorbid lifetime anxiety disorder ( N=177 ) or without a comorbid lifetime anxiety disorder ( N=92 ) were included in the analysis . Participants with a lifetime anxiety disorder were more likely to recover with psychotherapy than with collaborative care ( 66 % compared with 49 % recovered over 1 year ; number needed to treat=5.88 , small to medium effect ) . For patients without a lifetime anxiety disorder , there was no difference between rates of recovery in psychotherapy compared with collaborative care ( 64 % compared with 62 % recovered ; number needed to treat=50 , small effect ) . Participants with one lifetime anxiety disorder were likely to benefit from intensive psychotherapy compared with collaborative care ( 84 % compared with 53 % recovered ; number needed to treat=3.22 , medium to large effect ) , whereas patients with multiple anxiety disorders exhibited no difference in response to the two treatments ( 54 % compared with 46 % recovered ; number needed to treat=12.5 , small effect ) . CONCLUSIONS Depressed patients with bipolar disorder and comorbid anxiety may be in particular need of additional psychotherapy for treating acute depression . These results need to be replicated in studies that stratify bipolar patients to treatments based on their anxiety comorbidity status
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 .