{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T07:06:56Z","timestamp":1788937616568,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate pharmacological treatment patterns in individuals with bipolar disorder (BD) with and without comorbid substance use disorder (SUD) and anxiety disorder (AX), we leveraged the Global Bipolar Cohort to analyze cross\u2010regional practices across North America, Europe, and the Pacific.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fourteen cohorts contributed aggregate data on pharmacotherapy, demographics, diagnostic subtypes, and comorbidities. Proportional meta\u2010analyses using generalized linear mixed models were conducted to examine prescription trends and identify clinical differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The sample (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200911,521) was 60% female and 84% Caucasian. Participants were categorized into four mutually exclusive groups based on comorbidity status: those with comorbid AX only, comorbid SUD only, both AX and SUD, or neither. The AX+SUD subgroup showed higher rates of attention\u2010deficit\/hyperactivity disorder (ADHD), post\u2010traumatic stress disorder (PTSD), rapid cycling, obesity, and unemployment, reflecting a more severe clinical profile. Regional variations were notable: North American cohorts reported higher prevalence of AX and SUD than European and Pacific cohorts. Antidepressants use for AX were more common in Europe and the Pacific, while North American prescribing patterns were more variable. Benzodiazepine use was high among individuals with SUD across all regions. Lithium and first\u2010generation antipsychotic prescriptions varied, with higher rates observed in Europe.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Findings underscore the heterogeneity of BD and the influence of comorbid AX and SUD on illness burden and treatment. Regional prescribing variations underscore the need for context\u2010specific guidelines. Gaps in data on medication\u2010assisted treatment for SUD point to areas for future research. These insights can support more individualized and effective care for complex BD presentations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bdi.70167","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T11:39:43Z","timestamp":1786448383000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prescription Trends for Bipolar Disorder With and Without Comorbid Substance Use and Anxiety Disorders: A Global Bipolar Cohort Collaborative Study"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1592-0825","authenticated-orcid":false,"given":"Anastasia K.","family":"Yocum","sequence":"first","affiliation":[{"name":"Department of Psychiatry University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9544-3944","authenticated-orcid":false,"given":"Martin","family":"Alda","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Dalhousie University  Halifax Nova Scotia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Aouizerate","sequence":"additional","affiliation":[{"name":"Fondation FondaMental  Creteil France"},{"name":"Centre Hospitalier Charles Perrens, Laboratoire NutriNeuro (UMR INRA 1286), Universit\u00e9 de Bordeaux  Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie","family":"Aubin","sequence":"additional","affiliation":[{"name":"Fondation FondaMental  Creteil France"},{"name":"P\u00f4le de Psychiatrie Centre Hospitalier Princesse Grace  Monaco Monaco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3660-6640","authenticated-orcid":false,"given":"Frank","family":"Bellivier","sequence":"additional","affiliation":[{"name":"Fondation FondaMental  Creteil France"},{"name":"Optimisation Th\u00e9rapeutique en Neuropharmacologie, Universit\u00e9 Paris Cit\u00e9, INSERM UMRS 1144  Paris France"},{"name":"D\u00e9partement de Psychiatrie et de M\u00e9decine Addictologique, H\u00f4pitaux Lariboisi\u00e8re\u2010Fernand Widal, DMU Neurosciences, AP\u2010HP.Nord Universit\u00e9 Paris Cit\u00e9  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1222-6050","authenticated-orcid":false,"given":"Raoul","family":"Belzeaux","sequence":"additional","affiliation":[{"name":"Fondation FondaMental  Creteil France"},{"name":"Department of Psychiatry and Addictology University Hospital Center  Montpellier France"},{"name":"IGF, Univ. Montpellier, CNRS, INSERM  Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5554-6946","authenticated-orcid":false,"given":"Michael","family":"Berk","sequence":"additional","affiliation":[{"name":"Deakin Institute for Mental and Physical Health and Clinical Translation (Deakin IMPACT), School of Medicine Deakin University  Melbourne Victoria Australia"},{"name":"Mental Health Drug and Alcohol Services, Barwon Health University Hospital Geelong  Geelong Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9350-4440","authenticated-orcid":false,"given":"Joanna M.","family":"Biernacka","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychology Mayo Clinic  Rochester Minnesota USA"},{"name":"Department of Quantitative Health Sciences Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7301-9157","authenticated-orcid":false,"given":"Monika","family":"Budde","sequence":"additional","affiliation":[{"name":"Institute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Medizin Ludwig\u2010Maximilians\u2010Universit\u00e4t M\u00fcnchen  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4417-4988","authenticated-orcid":false,"given":"Katherine E.","family":"Burdick","sequence":"additional","affiliation":[{"name":"Vagelos College of Physicians and Surgeons Columbia University  New York New York USA"},{"name":"New York State Psychiatric Institute  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8662-2457","authenticated-orcid":false,"given":"Yun\u2010Hsuan","family":"Chang","sequence":"additional","affiliation":[{"name":"Institute of Gerontology, College of Medicine National Cheng Kung University  Tainan Taiwan"},{"name":"Institute of Behavioral Medicine, College of Medicine National Cheng Kung University  Tainan Taiwan"},{"name":"Department of Psychology National Cheng Kung University  Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon J.","family":"Coombes","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6519-8586","authenticated-orcid":false,"given":"Philippe","family":"Courtet","sequence":"additional","affiliation":[{"name":"Fondation FondaMental  Creteil France"},{"name":"IGF, Univ. 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Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences  Grenoble France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romain","family":"Rey","sequence":"additional","affiliation":[{"name":"Fondation FondaMental  Creteil France"},{"name":"Bipolar Disorder Expert Centre Le Vinatier Hospital  Bron France"},{"name":"University Lyon 1  Villeurbanne France"},{"name":"Inserm U1028, CNRS UMR5292, Lyon Neuroscience Research Center Psychiatric Disorders, Neuroscience Research and Clinical Research Team  Lyon France"},{"name":"Lyon Neuroscience Research Center, Psychiatric Disorders Neuroscience Research and Clinical Research Team  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"Roberts","sequence":"additional","affiliation":[{"name":"Discipline of Psychiatry and Mental Health, School of Clinical Medicine University of New South Wales  Sydney New South Wales 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