Bipolar-panic comorbidity in the general population: prevalence and associated morbidity

The goal of this study was to determine the prevalence, psychiatric comorbidity, panic symptomotology and physical morbidity associated with the co-occurrence of bipolar disorder and panic attacks in the general population.

Data were drawn from the National Comorbidity Survey, a community-based household sample (n=8098) representative of the US adult population aged 15-54. F tests were used to determine differences in sociodemographic characteristics, panic symptoms, physical and psychiatric morbidity between individuals with bipolar disorder with and without co-occurring panic attacks (lifetime). Multiple logistic regression analyses were used to identify sociodemographic and psychiatric correlates of the co-occurrence of bipolar disorder and panic attacks.

The co-occurrence of bipolar disorder and panic attacks was associated with earlier onset of panic attack [17.1 (8.7) years vs. 22.0 (10.3) years, F=8.3, df=1, 429, P=0.004] and significantly greater panic symptomotology (P<0.0001). Comorbid substance dependence [OR=5.8 (2.6, 13.0)], specific phobia [OR=3.3 (1.4, 7.6)], and GAD [OR=2.9 (1.3, 6.8)] were each independent correlates of the co-occurrence bipolar disorder and panic attacks.

These findings are consistent with, and extend, results from clinical studies showing that panic attacks are not uncommon, and are associated with significantly elevated rates of comorbid psychopathology, among individuals with bipolar disorder in the general population. Future studies that examine the relationship between panic attacks and bipolar disorder using a longitudinal design may be helpful in improving our understanding of the mechanism of this association.