The effects of pharmacological and psychotherapeutic treatment of comorbid anxiety disorders in patients with bipolar disorder

W.A.M. van der Veen, J. W. Renes, R. W. Kupka, Ej Receer

Research output: Contribution to journalArticleProfessional

Abstract

BACKGROUND: Theco-occurrence of bipolar disorder and anxiety disorder is associated with a worse prognosis. Clinical guidelines do not give clear therapeutic recommendations on this subject. AIM To review the evidence on the effectiveness of both psychotherapy and pharmacotherapy for anxiety disorders in patients with a bipolar disorder. METHOD: A systematic search in PubMed, Embase, Cochrane en PSVCINFO and subsequent screening of potential studies resulted in n included studies. RESULTS: Five studies examined the effect of pharmacotherapy on treatment of comorbid anxiety disorders. One of these studies showed that both olanzapine and lamotrigine provided positive results in treating the anxiety disorders, with olanzapine being the more effective of the two. Conflicting results were found for quetiapine and valproic acid. The conclusion of one study was that risperidone was not effective. No studies were found researching the effect of psychotherapy on treatment of comorbid anxiety disorders. However, two case studies and four studies that included patients with mixed diagnoses, including bipolar disorder, proposed evidence that behavioral and cognitive behavioral therapy (CBT) had a positive effect on treatment of the comorbid anxiety disorder. CONCLUSION: There is little evidence on the treatment of comorbid anxiety disorders in people with bipolar disorder. Psychotherapy is preferred due to the uncertainty of the effects of pharmacotherapy and the associated risk of causing side effects. Pharmacotherapy can be considered in cases where this is insufficiently effective.

Translated title of the contributionThe effects of pharmacological and psychotherapeutic treatment of comorbid anxiety disorders in patients with bipolar disorder
Original languageDutch
Pages (from-to)388-396
Number of pages9
JournalTijdschrift voor Psychiatrie
Volume60
Issue number6
Publication statusPublished - 1 Jun 2018

Cite this

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title = "De effectiviteit van medicamenteuze en psychotherapeutische behandeling van comorbide angststoornissen bij pati{\"e}nten met bipolaire stoornis",
abstract = "BACKGROUND: Theco-occurrence of bipolar disorder and anxiety disorder is associated with a worse prognosis. Clinical guidelines do not give clear therapeutic recommendations on this subject. AIM To review the evidence on the effectiveness of both psychotherapy and pharmacotherapy for anxiety disorders in patients with a bipolar disorder. METHOD: A systematic search in PubMed, Embase, Cochrane en PSVCINFO and subsequent screening of potential studies resulted in n included studies. RESULTS: Five studies examined the effect of pharmacotherapy on treatment of comorbid anxiety disorders. One of these studies showed that both olanzapine and lamotrigine provided positive results in treating the anxiety disorders, with olanzapine being the more effective of the two. Conflicting results were found for quetiapine and valproic acid. The conclusion of one study was that risperidone was not effective. No studies were found researching the effect of psychotherapy on treatment of comorbid anxiety disorders. However, two case studies and four studies that included patients with mixed diagnoses, including bipolar disorder, proposed evidence that behavioral and cognitive behavioral therapy (CBT) had a positive effect on treatment of the comorbid anxiety disorder. CONCLUSION: There is little evidence on the treatment of comorbid anxiety disorders in people with bipolar disorder. Psychotherapy is preferred due to the uncertainty of the effects of pharmacotherapy and the associated risk of causing side effects. Pharmacotherapy can be considered in cases where this is insufficiently effective.",
keywords = "Anxiety disorder, Bipolar disorder, Pharmacotherapy, Psychotherapy, Treatment",
author = "{van der Veen}, W.A.M. and Renes, {J. W.} and Kupka, {R. W.} and Ej Receer",
year = "2018",
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De effectiviteit van medicamenteuze en psychotherapeutische behandeling van comorbide angststoornissen bij patiënten met bipolaire stoornis. / van der Veen, W.A.M.; Renes, J. W.; Kupka, R. W.; Receer, Ej.

In: Tijdschrift voor Psychiatrie, Vol. 60, No. 6, 01.06.2018, p. 388-396.

Research output: Contribution to journalArticleProfessional

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T1 - De effectiviteit van medicamenteuze en psychotherapeutische behandeling van comorbide angststoornissen bij patiënten met bipolaire stoornis

AU - van der Veen, W.A.M.

AU - Renes, J. W.

AU - Kupka, R. W.

AU - Receer, Ej

PY - 2018/6/1

Y1 - 2018/6/1

N2 - BACKGROUND: Theco-occurrence of bipolar disorder and anxiety disorder is associated with a worse prognosis. Clinical guidelines do not give clear therapeutic recommendations on this subject. AIM To review the evidence on the effectiveness of both psychotherapy and pharmacotherapy for anxiety disorders in patients with a bipolar disorder. METHOD: A systematic search in PubMed, Embase, Cochrane en PSVCINFO and subsequent screening of potential studies resulted in n included studies. RESULTS: Five studies examined the effect of pharmacotherapy on treatment of comorbid anxiety disorders. One of these studies showed that both olanzapine and lamotrigine provided positive results in treating the anxiety disorders, with olanzapine being the more effective of the two. Conflicting results were found for quetiapine and valproic acid. The conclusion of one study was that risperidone was not effective. No studies were found researching the effect of psychotherapy on treatment of comorbid anxiety disorders. However, two case studies and four studies that included patients with mixed diagnoses, including bipolar disorder, proposed evidence that behavioral and cognitive behavioral therapy (CBT) had a positive effect on treatment of the comorbid anxiety disorder. CONCLUSION: There is little evidence on the treatment of comorbid anxiety disorders in people with bipolar disorder. Psychotherapy is preferred due to the uncertainty of the effects of pharmacotherapy and the associated risk of causing side effects. Pharmacotherapy can be considered in cases where this is insufficiently effective.

AB - BACKGROUND: Theco-occurrence of bipolar disorder and anxiety disorder is associated with a worse prognosis. Clinical guidelines do not give clear therapeutic recommendations on this subject. AIM To review the evidence on the effectiveness of both psychotherapy and pharmacotherapy for anxiety disorders in patients with a bipolar disorder. METHOD: A systematic search in PubMed, Embase, Cochrane en PSVCINFO and subsequent screening of potential studies resulted in n included studies. RESULTS: Five studies examined the effect of pharmacotherapy on treatment of comorbid anxiety disorders. One of these studies showed that both olanzapine and lamotrigine provided positive results in treating the anxiety disorders, with olanzapine being the more effective of the two. Conflicting results were found for quetiapine and valproic acid. The conclusion of one study was that risperidone was not effective. No studies were found researching the effect of psychotherapy on treatment of comorbid anxiety disorders. However, two case studies and four studies that included patients with mixed diagnoses, including bipolar disorder, proposed evidence that behavioral and cognitive behavioral therapy (CBT) had a positive effect on treatment of the comorbid anxiety disorder. CONCLUSION: There is little evidence on the treatment of comorbid anxiety disorders in people with bipolar disorder. Psychotherapy is preferred due to the uncertainty of the effects of pharmacotherapy and the associated risk of causing side effects. Pharmacotherapy can be considered in cases where this is insufficiently effective.

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