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The specific burden of comorbid anxiety disorders and of substance use disorders in bipolar I disorder.
Bipolar Disord. 2008 Feb; 10(1):67-78.BD

Abstract

OBJECTIVES

Uncertainty exists regarding whether comorbid substance use disorders (SUDs) in bipolar I disorder are more prevalent among persons with versus without comorbid anxiety disorders. Moreover, the independent contribution of these comorbidities to the burden of bipolar disorder (BD) is unclear.

METHODS

The 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions was used to identify respondents with lifetime BD (n = 1,411). Illness severity was compared across four groups based on the presence of lifetime anxiety disorders, lifetime SUDs, neither, or both. Variables included lifetime prevalence of mixed mania, prolonged mood episodes, BD-related health service utilization, and forensic history, 12-month prevalence of mania and depression, and current general mental health functioning. Diagnoses were generated using the National Institute on Alcohol Abuse and Alcoholism Alcohol Use Disorder and Associated Disabilities Interview Schedule, DSM-IV Version. Analyses were computed separately for males and females.

RESULTS

For females only, the lifetime prevalence of SUDs was significantly greater among those with lifetime anxiety disorders [odds ratio (OR) = 1.41, 95% confidence interval (CI) = 1.08-1.86]; this was not found among males (OR = 1.15, 95% CI = 0.79-1.68). In multiple logistic regression analyses among both males and females, anxiety disorders were significantly associated with mixed episodes, prolonged depressive episodes, 12-month prevalence of depression, BD-related health service utilization, and poorer current mental health functioning. SUDs were significantly associated with mixed episodes among females, 12-month prevalence of depression among males, and with forensic history among both males and females.

CONCLUSIONS

Whereas comorbid anxiety disorders appear to confer increased liability towards poor mental health functioning and greater BD-related health service utilization, comorbid SUDs are associated with positive forensic history. Early identification and treatment of these comorbid conditions are of paramount importance. Further representative prospective studies are needed.

Authors+Show Affiliations

Mood Disorders Program, Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada. benjamin.goldstein@utoronto.caNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

18199243

Citation

Goldstein, Benjamin I., and Anthony J. Levitt. "The Specific Burden of Comorbid Anxiety Disorders and of Substance Use Disorders in Bipolar I Disorder." Bipolar Disorders, vol. 10, no. 1, 2008, pp. 67-78.
Goldstein BI, Levitt AJ. The specific burden of comorbid anxiety disorders and of substance use disorders in bipolar I disorder. Bipolar Disord. 2008;10(1):67-78.
Goldstein, B. I., & Levitt, A. J. (2008). The specific burden of comorbid anxiety disorders and of substance use disorders in bipolar I disorder. Bipolar Disorders, 10(1), 67-78. https://doi.org/10.1111/j.1399-5618.2008.00461.x
Goldstein BI, Levitt AJ. The Specific Burden of Comorbid Anxiety Disorders and of Substance Use Disorders in Bipolar I Disorder. Bipolar Disord. 2008;10(1):67-78. PubMed PMID: 18199243.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The specific burden of comorbid anxiety disorders and of substance use disorders in bipolar I disorder. AU - Goldstein,Benjamin I, AU - Levitt,Anthony J, PY - 2008/1/18/pubmed PY - 2008/5/31/medline PY - 2008/1/18/entrez SP - 67 EP - 78 JF - Bipolar disorders JO - Bipolar Disord VL - 10 IS - 1 N2 - OBJECTIVES: Uncertainty exists regarding whether comorbid substance use disorders (SUDs) in bipolar I disorder are more prevalent among persons with versus without comorbid anxiety disorders. Moreover, the independent contribution of these comorbidities to the burden of bipolar disorder (BD) is unclear. METHODS: The 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions was used to identify respondents with lifetime BD (n = 1,411). Illness severity was compared across four groups based on the presence of lifetime anxiety disorders, lifetime SUDs, neither, or both. Variables included lifetime prevalence of mixed mania, prolonged mood episodes, BD-related health service utilization, and forensic history, 12-month prevalence of mania and depression, and current general mental health functioning. Diagnoses were generated using the National Institute on Alcohol Abuse and Alcoholism Alcohol Use Disorder and Associated Disabilities Interview Schedule, DSM-IV Version. Analyses were computed separately for males and females. RESULTS: For females only, the lifetime prevalence of SUDs was significantly greater among those with lifetime anxiety disorders [odds ratio (OR) = 1.41, 95% confidence interval (CI) = 1.08-1.86]; this was not found among males (OR = 1.15, 95% CI = 0.79-1.68). In multiple logistic regression analyses among both males and females, anxiety disorders were significantly associated with mixed episodes, prolonged depressive episodes, 12-month prevalence of depression, BD-related health service utilization, and poorer current mental health functioning. SUDs were significantly associated with mixed episodes among females, 12-month prevalence of depression among males, and with forensic history among both males and females. CONCLUSIONS: Whereas comorbid anxiety disorders appear to confer increased liability towards poor mental health functioning and greater BD-related health service utilization, comorbid SUDs are associated with positive forensic history. Early identification and treatment of these comorbid conditions are of paramount importance. Further representative prospective studies are needed. SN - 1398-5647 UR - https://www.unboundmedicine.com/medline/citation/18199243/The_specific_burden_of_comorbid_anxiety_disorders_and_of_substance_use_disorders_in_bipolar_I_disorder_ L2 - https://doi.org/10.1111/j.1399-5618.2008.00461.x DB - PRIME DP - Unbound Medicine ER -