[Comorbid anxiety disorders in bipolar disorder patients: a review]

In recent years, a growing number of clinical and epidemiological studies have reported high rates of comorbid anxiety disorder in patients with bipolar disorder. These studies have stated that comorbid anxiety disorder in bipolar patients is the rule rather than the exception. Lifetime anxiety disorder comorbidity rates among bipolar disorder patients are estimated to be between 24% and 93%, based on several different clinical and epidemiological studies. Bipolar patients usually are diagnosed with comorbid multiple anxiety disorders rather than a single one. Anxiety disorder comorbidity is associated with greater psychopathology, decreased treatment response, poor outcome, and increased suicidality. Current prevalent treatment approaches almost always give priority to the symptomatic treatment of bipolar episodes, which inevitably influences the provision of adequate attention and care to the diagnosis and treatment of a comorbid anxiety disorder. This approach has important therapeutic and clinical implications, such as delays in treatment leading to resistance to drugs and severe functional losses. Therefore, the treating psychiatrist needs to carefully evaluate, diagnose, and treat comorbid anxiety disorders in the early stages to avoid any unpleasant consequences and to improve the quality of life of patients. In this paper, an overview of comorbid anxiety disorder in bipolar disorders is presented, with a special emphasis on its prevalence, its relationship to sociodemographic and clinical variables, and possible therapeutic approaches.