Comorbidity of Anxiety Disorders and Substance Abusewith Bipolar Mood Disorders and Relationship with ClinicalCourse

Patients with bipolar mood disorder constitute a relatively large number of individuals hospitalized in psychiatric hospitals. This disorder is highly comorbid with other psychiatric disorders and may effect their clinical course. The goal of this study was to determine the co-occurrence rate of anxiety disorders and substance abuse with bipolar mood disorders and their impact on clinical course.153 bipolar patients (type I) were selected among the hospitalized patients at Razi Psychiatric Hospital in Tabriz, Iran, from September 2007 to October 2008 through convenience sampling method. The participants were evaluated by a structured clinical interview based on DSM-IV criteria (SCID), Hamilton Rating Scale for Depression (HRSD) and Young Mania Rating Scale(YMRS). Co-morbidity of anxiety disorders was 46.15%. Occurrence of anxiety disorders was 28% for obsessive-compulsive disorder, 26.6% for generalized anxiety disorder, 4.2% for phobia and 2.1% for panic disorder. Co-morbidity of substance abuse was 7.7% and the highest occurrence of substance abuse was 5.6% for alcoholism and 4.2% for opium. No significant difference was observed between the severity of disease and duration of hospitalization in bipolar patients with or without anxiety disorder. The severity of disease and duration of hospitalization in bipolar patients with substance abuse was higher compared to bipolar patients without substance abuse (P<0.05). This study suggests that there is a high co-morbidity between anxiety disorders and substance abuse with bipolar disorder. Further, this study suggests that co-occurrence of substance abuse disorder with bipolar disorder increases the everity of the disease and duration of hospitalization.