Alcoholism and anxiety in bipolar illness: Differential lifetime anxiety comorbidity in bipolar I women with and without alcoholism

Eric Levander, Mark A. Frye, Susan McElroy, Trisha Suppes, Heinz Grunze, Willem A. Nolen, Ralph Kupka, Paul E. Keck, Gabriele S. Leverich, Lori L. Altshuler, Sun Hwang, Jim Mintz, Robert M. Post

Research output: Contribution to journalArticlepeer-review

42 Scopus citations


Introduction: This study was undertaken to evaluate the prevalence rate of anxiety comorbidity in bipolar subjects with and without alcohol use disorders (AUD). Methods: Bipolar men and women who entered the Stanley Foundation Bipolar Network (SFBN) underwent a Structured Clinical Interview for DSM-IV (SCID-IV) and were divided into those subjects meeting current or lifetime criteria for an alcohol use disorder (AUD = 213) vs. those subjects who did not (non-AUD = 137). Lifetime rates of comorbid anxiety disorder were evaluated between groups. Results: Of 350 subjects, 163 (46.5%) met criteria for an anxiety disorder. Panic disorder and OCD were the most common anxiety disorders in the AUD and non-AUD groups. OCD and specific phobia were significantly less prevalent in BP I patients with AUD compared to those without. Bipolar women with AUD had a significantly higher rate of PTSD than those without. Conclusion: These data highlight the added liability of anxiety comorbidity in BP disorder. Specifically, the greater amount of PTSD and lesser amount of OCD in bipolar women with alcohol comorbidity may have important diagnostic and treatment implications beyond dual diagnosis. Further study in comorbidity patterns is encouraged to not only better understand illness burden, but to maximize pattern-specific treatment outcomes.

Original languageEnglish (US)
Pages (from-to)211-217
Number of pages7
JournalJournal of Affective Disorders
Issue number1-3
StatePublished - Aug 2007


  • Alcoholism
  • Bipolar disorder
  • Dual diagnosis
  • PTSD
  • Women

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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