Comorbid Anxiety Disorders in Canadians with Bipolar Disorder: Clinical Characteristics and Service Use

Abstract

Objective: To examine the impact of anxiety disorders comorbid to bipolar disorder (BD) in a large, nationally representative sample, to describe the sociodemographic and clinical profiles of Canadians living with BD and with or without comorbid anxiety disorders, to identify the characteristics uniquely associated with comorbid anxiety, and to examine treatment patterns. Method: We analyzed data from the Canadian Community Health Survey: Mental Health and Well-Being, conducted among 38 492 Canadians. People meeting the criteria for BD ( n = 808) were compared based on the presence or absence of an assessed anxiety disorder (that is, social phobia, panic disorder, and agoraphobia). Results: People with BD and a comorbid anxiety disorder fare worse in terms of BD relapses, suicidality, and sleep disturbance, and are more likely to be taking psychiatric medication. They have more impairment in their work and social functioning and rate their health and life satisfaction lower. Despite the greater severity, they are not receiving additional psychological treatment, they feel they are not receiving the treatment they need, and they report more barriers to treatment. Conclusions: This study confirms the critical impact of comorbid anxiety on the course of BD in a large, nationally representative sample and reveals that the psychological treatment needs of this population are not being met. Clinical and research implications are discussed.

Potentially inappropriate psychotropic prescription at discharge is associated with lower functioning in the elderly psychiatric inpatients. A cross-sectional study

“…This is probably due to the fact that anxiety and sleep disorders are commonly comorbid with all psychiatric disorders (Xiang et al 2009;Lijun et al 2012;Hawke et al 2013;Wiegner et al 2015). Moreover, no association between hospitalization duration and PIP prescription has been found.…”

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

“…Clinical samples indicate that 24%‐56% of patients with BD meet criteria for one or more anxiety disorders, with the highest rates in women 720. Comorbid anxiety symptoms and anxiety disorders are associated with a higher number of mood episodes and depressive symptoms, including suicidality and sleep disturbance, and greater impairment of psychosocial functioning and quality of life 721. The presence of a comorbid anxiety disorder is also associated with high rates of use of antidepressants,722 which should be employed with caution due to their potential for mood destabilization (Section 4).…”

Co-Occurrence of Anxiety and Bipolar Disorders: Clinical and Therapeutic Overview

“…[30][31][32][33][34][35] Findings pertaining to prevalence of anxiety syndromes in BD patients derive from both epidemiological [4,30,[36][37][38][39][40][41][42][43] and clinical studies. [30][31][32][33][34][35] Findings pertaining to prevalence of anxiety syndromes in BD patients derive from both epidemiological [4,30,[36][37][38][39][40][41][42][43] and clinical studies.…”