Research report Alcoholism and anxiety in bipolar illness: Differential lifetime anxiety comorbidity in bipolar I women with and without alcoholism ☆ Eric Levander a , Mark A. Frye a, ⁎ , Susan McElroy b , Trisha Suppes c , Heinz Grunze d , Willem A. Nolen e,f , Ralph Kupka f , Paul E. Keck Jr. b , Gabriele S. Leverich g , Lori L. Altshuler a , Sun Hwang a , Jim Mintz a , Robert M. Post g a Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, United States b Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States c Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas, United States d Department of Psychiatry, LMU Munich, Munich Germany e Department of Psychiatry, University Medical Center, University of Groningen, Groningen, The Netherlands f Altrecht Institute for Mental Health Care, Utrecht, The Netherlands g Biological Psychiatry Branch, NIMH, NIH, Bethesda, Maryland, United States Received 9 September 2006; received in revised form 14 November 2006; accepted 28 November 2006 Available online 23 January 2007 Abstract 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. © 2007 Elsevier B.V. All rights reserved. Keywords: Bipolar disorder; Alcoholism; Dual diagnosis; PTSD; Women Journal of Affective Disorders 101 (2007) 211 – 217 www.elsevier.com/locate/jad ☆ Presented at the 4th European Stanley Conference on Bipolar Disorder, Aarhus Denmark September 2005. We gratefully acknowledge the support of the Stanley Medical Research Institute for the funding of this naturalistic study and to Abbott Laboratories for an educational grant for fellowship support (Dr. Levander). ⁎ Corresponding author. Department of Psychiatry and Psychology, Mayo Clinic, 200 First St. SW, Rochester MN 55905, United States. Tel.: +1 507 255 1475; fax: +1 507 255 9416. E-mail address: mfrye@mayo.edu (M.A. Frye). 0165-0327/$ - see front matter © 2007 Elsevier B.V. All rights reserved. doi:10.1016/j.jad.2006.11.023