Co-Morbidity Part 2 - Neurobiology and Suicide Risk; Modelling the consequences of Bipolar and Anxiety Co-Morbidity.

We review the evidence that Bipolar Disorder with Comorbid Anxiety, Rapid Cycling Bipolar Disorder, Mixed Affective states, are all related to each other and to Dopamine Transmission in Bipolar Disorder. All these states are related to the presence of particular polymorphisms of the genes of the D2 and D3 receptors. All these states increase the risk of suicidality. Substance and alcohol abuse comorbid with bipolar disorder increases the risk of both Rapid Cycling and Suicidality. We present a model which demonstrates these relationships.