Comorbid Anxiety Disorders in Canadians with Bipolar Disorder: Clinical Characteristics and Service Use
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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.
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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.
“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”
From Canadian Network for Mood and Anxiety Treatments ( <scp>CANMAT</scp> ) and International Society for Bipolar Disorders ( <scp>ISBD</scp> ) 2018 guidelines for the management of patients with bipolar disorder (2018) · cites this paper as [721]
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Experimental — accuracy not yet measuredPeople with comorbid bipolar and anxiety disorders report receiving inadequate treatment for their needs.
“However, people with comorbid bipolar and anxiety disorders report receiving inadequate treatment for their needs (Hawke, Provencher, Parikh, & Zagorski, 2013).”
From What are People's Experiences of a Novel Cognitive Behavioural Therapy for Bipolar Disorders? A Qualitative Investigation with Participants on the TEAMS Trial. (2017) · cites this paper as Hawke, Provencher, Parikh, & Zagorski, 2013
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Cites
Kessler, R. C., & Üstün, T. B. (2004) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.168 · Cited by 4,771 · see citing works
Merikangas, K. R., Akiskal, H. S., Angst, J., Greenberg, P. E., Hirschfeld, R. M. A., Petukhova, M., & Kessler, R. C. (2007) · Archives of General Psychiatry · doi:10.1001/archpsyc.64.5.543 · Cited by 2,399 · see citing works
Wittchen, H.-U. (1994) · Journal of Psychiatric Research · doi:10.1016/0022-3956(94)90036-1 · Cited by 2,348 · see citing works
Judd, L. L., & Akiskal, H. S. (2002) · Journal of Affective Disorders · doi:10.1016/s0165-0327(02)00332-4 · Cited by 737 · see citing works
Kessler, R. C., Merikangas, K. R., & Wang, P. S. (2007) · Annual Review of Clinical Psychology · doi:10.1146/annurev.clinpsy.3.022806.091444 · Cited by 468 · see citing works
The Canadian Community Health Survey: Mental Health and Well-Being
Gravel, R. G., & Béland, Y. (2005) · The Canadian Journal of Psychiatry · doi:10.1177/070674370505001002 · Cited by 306 · see citing works
The comorbidity of bipolar and anxiety disorders: prevalence, psychobiology, and treatment issues
Freeman, M. P., Freeman, S. A., & McElroy, S. L. (2002) · Journal of Affective Disorders · doi:10.1016/s0165-0327(00)00299-8 · Cited by 303 · see citing works
(2004) · PubMed · Cited by 296 · see citing works
Sleep Disturbance in Bipolar Disorder: Therapeutic Implications
Plante, D. T., & Winkelman, J. W. (2008) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2008.08010077 · Cited by 268 · see citing works
Anxiety as a Correlate of Response to the Acute Treatment of Bipolar I Disorder
Feske, U. (2000) · American Journal of Psychiatry · doi:10.1176/appi.ajp.157.6.956 · Cited by 230 · see citing works
Otto, M. W., Simon, N. M., Wisniewski, S. R., Miklowitz, D. J., Kogan, J. N., Reilly-Harrington, N. A., Frank, E., Nierenberg, A. A., Marangell, L. B., Sagduyu, K., et al. (2006) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.104.007773 · Cited by 221 · see citing works
Annual cost of bipolar disorder to UK society
Gupta, R. D., & Guest, J. F. (2002) · The British Journal of Psychiatry · doi:10.1192/bjp.180.3.227 · Cited by 184 · see citing works
Simon, N. M., Zalta, A. K., Otto, M. W., Ostacher, M. J., Fischmann, D., Chow, C. W., Thompson, E. H., Stevens, J., Demopulos, C. M., Nierenberg, A. A., et al. (2006) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2006.08.004 · Cited by 180 · see citing works
Sub-syndromal and syndromal symptoms in the longitudinal course of bipolar disorder
Paykel, E. S., Abbott, R., Morriss, R. K., Hayhurst, H., & Scott, J. L. (2006) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.105.013870 · Cited by 158 · see citing works
Community Survey of Bipolar Disorder in Canada: Lifetime Prevalence and Illness Characteristics
Schaffer, A., Cairney, J., Cheung, A., Veldhuizen, S., & Levitt, A. (2006) · The Canadian Journal of Psychiatry · doi:10.1177/070674370605100104 · Cited by 143 · see citing works
Brissos, S., Dias, V. V., Carita, A. I., & Martínez‐Arán, A. (2008) · Psychiatry Research · doi:10.1016/j.psychres.2007.04.010 · Cited by 130 · see citing works
Substance use disorders and suicide attempts in bipolar subtypes
Sublette, M. E., Carballo, J. J., Moreno, C., Galfalvy, H., Brent, D. A., Birmaher, B. B., Mann, J. J., & Oquendo, M. A. (2008) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2008.05.001 · Cited by 117 · see citing works
Albert, U., Rosso, G., Maina, G., & Bogetto, F. (2007) · Journal of Affective Disorders · doi:10.1016/j.jad.2007.05.020 · Cited by 105 · see citing works
(2012) · PubMed · Cited by 100 · see citing works
Anxiety and Outcome in Bipolar Disorder
Coryell, W. H., Solomon, D. A., Fiedorowicz, J. G., Endicott, J., Schettler, P. J., & Judd, L. L. (2009) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2009.09020218 · Cited by 89 · see citing works
Parsing the Comorbidity Between Bipolar Disorder and Anxiety Disorders: A Familial Risk Analysis
Wozniak, J. R., Biederman, J., Monuteaux, M. C., Richards, J., & Faraone, S. V. (2002) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/104454602760219144 · Cited by 88 · see citing works
Comorbid Anxiety in Bipolar Disorder Alters Treatment and Prognosis
El‐Mallakh, R. S., & Hollifield, M. A. (2008) · Psychiatric Quarterly · doi:10.1007/s11126-008-9071-5 · Cited by 76 · see citing works
Bipolar comorbidity: from diagnostic dilemmas to therapeutic challenge
Sasson, Y., Chopra, M., Harrari, E., Amitai, K., & Zohar, J. (2003) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145703003432 · Cited by 71 · see citing works
Psychotherapies for comorbid anxiety in bipolar spectrum disorders
Provencher, M. D., Hawke, L. D., & Thienot, E. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2010.10.040 · Cited by 62 · see citing works
Self-citationA population-based analysis of distinguishers of bipolar disorder from major depressive disorder
Schaffer, A., Cairney, J., Veldhuizen, S., Kurdyak, P., Cheung, A., & Levitt, A. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2010.02.118 · Cited by 53 · see citing works
Stensland, M. D., Jacobson, J. G., & Nyhuis, A. W. (2007) · Journal of Affective Disorders · doi:10.1016/j.jad.2006.11.019 · Cited by 51 · see citing works
Comorbid anxiety in bipolar spectrum disorders: A neglected research and treatment issue?
Provencher, M. D., Guimond, A., & Hawke, L. D. (2011) · Journal of Affective Disorders · doi:10.1016/j.jad.2011.12.001 · Cited by 49 · see citing works
Self-citationEpidemiology and Management of Anxiety in Patients with Bipolar Disorder
Kauer‐Sant’Anna, M., Kapczinski, F. P., & Vieta, E. (2009) · CNS Drugs · doi:10.2165/11310850-000000000-00000 · Cited by 44 · see citing works
Lee, S., Ng, K. L., & Tsang, A. (2009) · Journal of Affective Disorders · doi:10.1016/j.jad.2008.12.003 · Cited by 30 · see citing works
Inter‐episode mood lability in mood disorders: residual symptom or natural course of illness?
Benazzi, F. (2004) · Psychiatry and Clinical Neurosciences · doi:10.1111/j.1440-1819.2004.01289.x · Cited by 29 · see citing works
Rizvi, S. J., & Zaretsky, A. E. (2007) · Journal of Clinical Psychology · doi:10.1002/jclp.20370 · Cited by 29 · see citing works
Dilsaver, S. C., Benazzi, F., Akiskal, K. K., & Akiskal, H. S. (2008) · Bulletin of the Menninger Clinic · doi:10.1521/bumc.2008.72.2.130 · Cited by 28 · see citing works
Treating Chronic and Severe Mental Disorders: A Handbook of Empirically Supported Interventions
Sullivan, T. B. (2003) · Psychiatric Services · doi:10.1176/appi.ps.54.3.407 · Cited by 16 · see citing works
Fracalanza, K., McCabe, R. E., Taylor, V. H., & Antony, M. M. (2011) · The European Journal of Psychiatry · doi:10.4321/s0213-61632011000400005 · Cited by 7 · see citing works
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Yatham, L. N., Kennedy, S. H., Parikh, S. V., Schaffer, A., Bond, D. J., Frey, B. N., Sharma, V., Goldstein, B. I., Rej, S., Beaulieu, S., et al. (2018) · Bipolar Disorders · doi:10.1111/bdi.12609 · Cited by 1,852 · see citing works
Self-citationPavlova, B., Perlis, R. H., Alda, M., & Uher, R. (2015) · The Lancet Psychiatry · doi:10.1016/s2215-0366(15)00112-1 · Cited by 153 · see citing works
Stigma and bipolar disorder: A review of the literature
Hawke, L. D., Parikh, S. V., & Michalak, E. E. (2013) · Journal of Affective Disorders · doi:10.1016/j.jad.2013.05.030 · Cited by 145 · see citing works
Self-citationComorbidity of bipolar and anxiety disorders: An overview of trends in research
Spoorthy, M. S., Chakrabarti, S., & Grover, S. (2018) · World Journal of Psychiatry · doi:10.5498/wjp.v9.i1.7 · Cited by 125 · see citing works
CO-OCCURRENCE OF ANXIETY AND BIPOLAR DISORDERS: CLINICAL AND THERAPEUTIC OVERVIEW
Vázquez, G. H., Baldessarini, R. J., & Tondo, L. (2014) · Depression and Anxiety · doi:10.1002/da.22248 · Cited by 93 · see citing works
Keramatian, K., Chithra, N. K., & Yatham, L. N. (2023) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.20230009 · Cited by 104 · see citing works
Maes, M. H. J., Bonifácio, K. L., Morelli, N. R., Vargas, H. O., Moreira, E. G., Stoyanov, D., Barbosa, D. S., Carvalho, A. F., & Nunes, S. O. V. (2018) · Neurotoxicity Research · doi:10.1007/s12640-018-9906-2 · Cited by 76 · see citing works
Pavlova, B., Perlis, R. H., Mantere, O., Sellgren, C. M., Isometsä, E., Mitchell, P. B., Alda, M., & Uher, R. (2017) · Psychological Medicine · doi:10.1017/s0033291716003135 · Cited by 55 · see citing works
Early Maladaptive Schemas: Relationship With Case Complexity in Mood and Anxiety Disorders
Hawke, L. D., & Provencher, M. D. (2013) · Journal of Cognitive Psychotherapy · doi:10.1891/0889-8391.27.4.359 · Cited by 30 · see citing works
Self-citationStigma, Social Anxiety, and Illness Severity in Bipolar Disorder: Implications for Treatment
Levy, B., Tsoy, E., Brodt, M., Petrosyan, K., & Malloy, M. (2015) · Annals of Clinical Psychiatry · doi:10.1177/104012371502700110 · Cited by 26 · see citing works
Hawke, L. D., Velyvis, V., & Parikh, S. V. (2013) · International Journal of Bipolar Disorders · doi:10.1186/2194-7511-1-15 · Cited by 25 · see citing works
Self-citationAnxiety disorders and childhood maltreatment as predictors of outcome in bipolar disorder
Pavlová, B., Perroud, N. A., Cordera, P., Uher, R., Alda, M., Dayer, A. G., & Aubry, J. (2017) · Journal of Affective Disorders · doi:10.1016/j.jad.2017.08.048 · Cited by 24 · see citing works
Fond, G. B., Fajula, C., Dassa, D., Brunel, L., Lançon, C., & Boyer, L. (2016) · Psychopharmacology · doi:10.1007/s00213-016-4312-z · Cited by 19 · see citing works
Anxiety in bipolar disorder: A review of publication trends
Larocque, M. C., Fortin-Vidah, G., Angers, M., Garceau, L., Gros, L., Fournel, I., & Provencher, M. D. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.09.057 · Cited by 16 · see citing works
Self-citationJoyce, E., Tai, S., Gebbia, P., & Mansell, W. (2017) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2040 · Cited by 13 · see citing works
Brings, V. E., Lord, J. S., Diering, G. H., & Zylka, M. J. (2019) · Genes Brain & Behavior · doi:10.1111/gbb.12570 · Cited by 14 · see citing works
Amuk, O. C., & Patel, R. S. (2020) · Behavioral Sciences · doi:10.3390/bs10070108 · Cited by 11 · see citing works
Prisciandaro, J. J., Mellick, W. H., Mitaro, E., & Tolliver, B. K. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.12.070 · Cited by 9 · see citing works
The Effect of Lurasidone on Anxiety Symptoms in Patients With Bipolar Depression
Goldberg, J. F., SIU, C. O., Tocco, M., Pikalov, A., & Loebel, A. D. (2023) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.22m14732 · Cited by 7 · see citing works
Effects of comorbid anxiety disorders on the course of bipolar disorder-I
Buturak, Ş. V., & Koçak, O. M. (2015) · Nordic Journal of Psychiatry · doi:10.3109/08039488.2015.1014835 · Cited by 7 · see citing works
Berkol, T. D., Kırlı, E., İslam, S., Pınarbaşı, R., & Özyıldırım, İ. (2016) · Saudi Medical Journal · doi:10.15537/smj.2016.3.13108 · Cited by 7 · see citing works
Paholpak, S., Kongsakon, R., Pattanakumjorn, W., Wongsuriyadech, W., Srisurapanont, M., & Kanokvut, R. (2014) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s57019 · Cited by 6 · see citing works
Ruiz, J. S. S., Coombes, B., Pendegraft, R., Özerdem, A., McElroy, S., Cuéllar-Barboza, A., Prieto, M., Frye, M., Winham, S., & Biernacka, J. (2023) · Psychiatry Research · doi:10.1016/j.psychres.2023.115174 · Cited by 5 · see citing works
Mohamed, M., Fine, A., Fotinos, K., Welch, A., Kitchen, K., Rose, M., Hallett, D., Davis, M., Tsirgielis, C., Ambrosio, C. D., et al. (2017) · Journal of Psychology & Psychotherapy · doi:10.4172/2161-0487.1000304 · Cited by 1 · see citing works
Working with Anxiety Disorders in Bipolar Disorder
Provencher, M. D., Garceau, L., & Jones, S. H. (2024) · Springer eBooks · doi:10.1007/978-3-031-63349-2_19
Self-citation
- Authors
- Hawke, L. D., Provencher, M. D., Parikh, S. V., & Zagorski, B.
- Affiliations
- University Health Network (CA)
- Institut Universitaire en Santé Mentale de Québec (CA)
- University of Toronto (CA)
- Corresponding author
- Provencher, Martin D
- Venue
- The Canadian Journal of Psychiatry
- Publisher
- SAGE Publications
- Published
- 2013-07
- Volume
- 58
- Issue
- 7
- Pages
- 393-401
- ISSN
- 0706-7437 (ISSN-L)
- 1497-0015
- OpenAlex
- W2404281517
- Cited by
- 28
- References
- 34
- Citations by year
- 2024: 1 · 2023: 6 · 2022: 1 · 2020: 1 · 2019: 1 · 2018: 4 · 2017: 2 · 2016: 4 · 2015: 3 · 2014: 2 · 2013: 3
- FWCI
- 2.83
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Canadian Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- bipolar disorder, comorbid anxiety disorders, social anxiety disorder, panic disorder, agoraphobia, mental health service utilization, barriers to treatment, treatment needs, suicidality, sleep disorders, work and social functioning, life satisfaction, Canadian Community Health Survey
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Anxiety Disorders, Bipolar Disorder, Canada, Female, Health Surveys, Humans, Male, Mental Health Services, Middle Aged, Severity of Illness Index, Comorbidity, Young Adult
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