Illness course, comorbidity, gender, and suicidality in patients with bipolar disorder.

Among patients with bipolar disorder, comorbid conditions are common. Comorbidity is associated with a more difficult course of illness (such as longer episodes, shorter time euthymic, and earlier age at onset) and an increase in related problems (such as suicidality and violence). Data from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) reveal that anxiety disorders, attention-deficit/hyperactivity disorder, and substance and alcohol use disorder are conditions that commonly co-occur with bipolar disorder. This article details these findings and discusses the complications associated with these comorbid conditions. STEP-BD data about gender differences are also discussed, and correlates of suicidal ideation among patients entering the program are described.