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Substance abuse in bipolar disorder.

F Cassidy1, E P Ahearn, B J Carroll

  • 1Duke-Umstead Bipolar Disorders Program, Duke University, Durham, NC 27710, USA. cassi002@mc.duke.edu

Bipolar Disorders
|September 13, 2001
PubMed
Summary

Substance abuse is common in bipolar disorder patients, affecting nearly 60% of individuals. While rates decrease with age, recognizing and treating this comorbidity is crucial for managing bipolar disorder.

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Area of Science:

  • Psychiatry
  • Addiction Medicine
  • Clinical Psychology

Background:

  • Substance abuse is prevalent in the general population, with higher rates in males.
  • Bipolar disorder patients also exhibit high rates of substance abuse, but the connection is not fully understood.

Purpose of the Study:

  • To characterize the relationship between substance abuse and bipolar disorder.
  • To determine the rates of alcohol and drug abuse in patients with bipolar disorder.

Main Methods:

  • A cohort of 392 patients hospitalized for bipolar disorder (manic or mixed episodes) were assessed for substance abuse history.
  • Rates of lifetime and current substance abuse were calculated and compared across sex, bipolar subtype, and clinical history.

Main Results:

  • Lifetime substance abuse rates were high: 48.5% for alcohol and 43.9% for drugs, with nearly 60% reporting any lifetime abuse.
  • Males showed higher substance abuse rates than females. No differences were found between manic and mixed bipolar states.
  • Active substance abuse decreased in older individuals, but remained significant. Comorbid substance abuse was linked to more psychiatric hospitalizations.

Conclusions:

  • Substance abuse is a significant comorbidity in bipolar disorder, impacting a large proportion of patients.
  • Despite decreasing rates in older adults, substance abuse remains clinically relevant in the elderly bipolar population.
  • Comorbid substance abuse may indicate a more severe course of bipolar disorder, highlighting the need for integrated treatment.

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