Past studies have found a strong association of anxiety disorder with bipolar disorder [44,45]. We found that females with bipolar disorder were 1.6 times more likely to suffer from anxiety disorder compared to males. When compared with the general population, bipolar patients had a higher prevalence of comorbid anxiety in males (14.3% vs. 19.1% seen in bipolar patients) and females (23.4% vs. 28.2% seen in bipolar patients) [46]. An eating disorder was present in a very low proportion of total patients (0.1% males and 0.6% females), which is lower than that seen in the general population (0.4% males and 1% females) [47]. However, the females with bipolar disorder had 11-fold higher odds of having eating disorders with bipolar disorder than males in our study. There is an increased coexistence of bipolar disease with eating disorders in female patients, predominantly bulimia and anorexia nervosa [48,49]. In addition, the coexistence of bipolar disorder with an eating disorder has been reported to be associated with poor long-term outcomes and a severe disease course of bipolar disorder [49,50]. Alcohol use disorder and substance use
