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Prevalence of current anxiety disorders in people with bipolar disorder during euthymia: a meta-analysis

Published online by Cambridge University Press:  20 December 2016

B. Pavlova ,
R. H. Perlis ,
O. Mantere ,
C. M. Sellgren ,
E. Isometsä ,
P. B. Mitchell ,
M. Alda  and
R. Uher
B. Pavlova*
Affiliation:
Nova Scotia Health Authority, Halifax, Nova Scotia, Canada Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
R. H. Perlis
Affiliation:
Department of Psychiatry, Harvard Medical School, Boston, MA, USA
O. Mantere
Affiliation:
Douglas Mental Health University Institute, Montréal, Québec, Canada McGill University, Montréal, Québec, Canada
C. M. Sellgren
Affiliation:
Department of Psychiatry, Harvard Medical School, Boston, MA, USA Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
E. Isometsä
Affiliation:
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
P. B. Mitchell
Affiliation:
University of New South Wales, School of Psychiatry, Sydney, Australia Black Dog Institute, Sydney, New South Wales, Australia
M. Alda
Affiliation:
Nova Scotia Health Authority, Halifax, Nova Scotia, Canada Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
R. Uher
Affiliation:
Nova Scotia Health Authority, Halifax, Nova Scotia, Canada Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
*
*Address for correspondence: B. Pavlova, Department of Psychiatry, Dalhousie University, Mood Disorders Program, 5909 Veterans’ Memorial Lane, Halifax, B3H 2E2, NS, Canada. (Email: barbara.pavlova@dal.ca)
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Abstract

Background

Anxiety disorders are highly prevalent in people with bipolar disorder, but it is not clear how many have anxiety disorders even at times when they are free of major mood episodes. We aimed to establish what proportion of euthymic individuals with bipolar disorder meet diagnostic criteria for anxiety disorders.

Method

We performed a random-effects meta-analysis of prevalence rates of current DSM-III- and DSM-IV-defined anxiety disorders (panic disorder, agoraphobia, social anxiety disorder, generalized anxiety disorder, specific phobia, obsessive–compulsive disorder, post-traumatic stress disorder, and anxiety disorder not otherwise specified) in euthymic adults with bipolar disorder in studies published by 31 December 2015.

Results

Across 10 samples with 2120 individuals with bipolar disorder, 34.7% met diagnostic criteria for one or more anxiety disorders during euthymia [95% confidence interval (CI) 23.9–45.5%]. Direct comparison of 189 euthymic individuals with bipolar disorder and 17 109 population controls across three studies showed a 4.6-fold increase (risk ratio 4.60, 95% CI 2.37–8.92, p < 0.001) in prevalence of anxiety disorders in those with bipolar disorder.

Conclusions

These findings suggest that anxiety disorders are common in people with bipolar disorder even when their mood is adequately controlled. Euthymic people with bipolar disorder should be routinely assessed for anxiety disorders and anxiety-focused treatment should be initiated if indicated.

Keywords

Anxiety disordersbipolar disorderco-morbidityeuthymiameta-analyses
Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 6 , April 2017 , pp. 1107 - 1115
Copyright
Copyright © Cambridge University Press 2016 

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