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Psychiatr Q. 2008 Jun;79(2):139-50. doi: 10.1007/s11126-008-9071-5. Epub 2008 May 20.

Comorbid anxiety in bipolar disorder alters treatment and prognosis.

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  • 1Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, MedCenter One, 501 E Broadway, Louisville, KY 40202, USA.


Mood disorders in general, and bipolar disorder in particular, are unique among the psychiatric conditions in that they are associated with extraordinarily high rates of comorbidity with a multitude of psychiatric and medical conditions. Among all the potential comorbidities, co-occurring anxiety disorders stand out due to their very high prevalence. Outcome in bipolar illness is worse in the presence of a comorbid anxiety disorder. The coexistence of an anxiety disorder presents a particularly difficult challenge in the treatment of bipolar illness since antidepressants, the mainstay of pharmacologic treatments for anxiety, may adversely alter the course of manic-depression. Identification of anxiety disorders in bipolar patients is important. The treatment plan needs to balance the potential benefit and harm of antidepressant administration.

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