People with bipolar disorder (BD) have higher rates of substance-abuse disorder (SUD) and anxiety than the rest of the population but it is unclear how substance problems and anxiety interact in people with bipolar disorder and how having SUD and/or anxiety problems affect people's bipolar disorder. A Canadian study of 1,411 people with bipolar disorder attempted to find some answers to these questions. The study found that among women the lifetime prevalence of SUDs was significantly greater among those with anxiety disorders but that the same link was not found in men. Anxiety disorders were significantly associated with mixed episodes, prolonged depressive episodes, 12-month prevalence of depression, BD-related health-service utilization and poorer current mental health functioning. SUDs were significantly associated with mixed episodes among females, 12-months prevalence of depression among males and with trouble with the law in both genders.
Goldstein, Benjamin E. and Levitt, Anthony J. - The specific burden of comorbid anxiety disorders and of substance use disorders in Bipolar I disorder Bipolar Disorders February 2008, 10(1), 67-78