The specific burden of comorbid anxiety disorders and of substance use disorders in bipolar I disorder Bipolar Disorders 10 (1), 67–78.
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.
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.
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.
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