Background: Comorbid anxiety disorders are extremely prevalent in bipolar disorder (BD) and have substantial
impact on the course of illness. Limited evidence regarding treatment factors has led to a renewal of research
efforts examining both the impact of treatments on comorbid anxiety and the impact of comorbid anxiety on
treatments. The current study examines the impact of comorbid anxiety disorders on response to two psychosocial
interventions for BD.
Methods: A sample of 204 patients with BD took part in the study. Of them, 41.7% had a comorbid anxiety
disorder. All participants received either individual cognitive-behavioral therapy or group psychoeducation for BD.
Evaluations included complete pretreatment and 18-month follow-up assessments of mood and anxiety symptoms,
functioning, medication compliance, dysfunctional attitudes, and coping style. Outcome was compared based on
the presence or absence of a comorbid anxiety disorder.
Results and discussion: The participants with comorbid anxiety disorders ranked more severe than those without
on several measures. Despite more severe illness characteristics, the magnitude of their treatment gains was
equivalent or superior to that of the participants without anxiety disorders on a variety of outcome measures.
Although the treatments did not specifically target the anxiety disorder, the participants made significant
improvements in anxiety symptoms. Despite greater illness severity, patients with comorbid anxiety disorders can
make substantial gains from psychosocial interventions targeting BD. Even in the presence of an anxiety disorder,
they are able to attend to the content of the psychosocial treatments and apply it to better manage their
condition. The presence of a comorbid anxiety disorder should not be considered a deterrent to offering BDfocused
psychosocial treatments.
Keywords: Bipolar disorder; Anxiety disorders; Comorbidity; Cognitive-behavioral therapy; Psychoeducation