Skip to main content

Bipolar affective disorder and substance abuse

Author/s
Anton Grech
Citation
Issue 3 Summer 2013
CEPiP.2013;1:271-273
Abstract

Epidemiological studies show that substance abuse and bipolar disorder are strongly associated. The reasons include of self-treatment and poor self-control during hypomanic/manic periods. Substance abuse influences the outcome of bipolar disorder and makes diagnosis more difficult. Patients with bipolar disorder who abuse substances tend to have a worse outcome and greater suicidal risk. If good outcomes are to be achieved, substance abuse in these patients cannot be ignored. An integrated treatment approach of both conditions together probably gives the best results.

Keywords: substance abuse, alcohol, bipolar disorder, outcome, suicide, clinical implications

Cite as: Cutting Edge Psychiatry in Practice 2013, 3(1):271-273; https://doi.org/10.65031/rxic1884

References

  1. Salloum IM, Thase ME. Impact of substance abuse on the course and treatment of bipolar disorder. Bipolar Disorders 2000; 2: 269-280. https://doi.org/10.1034/j.1399-5618.2000.20308.x
  2. Regier DA, Farmer ME, Rae DS, Locke BZ, Keith SJ, JuddLL, Godwin FK. Comorbidity of mental disorders with alcohol and other drug abuse. Results from the the Epidemiological Catchment Area (ECA) study. JAMA 1990 Nov 21; 264 (19): 2511 - 2518. https://doi.org/10.1001/jama.1990.03450190043026
  3. Kessler RC, Crum RM, Warner LA, Nelson CB et al. Lifetime co-occurrence of DSM- III - R alcohol abuse and dependence with other psychiatric disorders in the National Comorbidity Survey. Arch Gen Psychiatr 1997 Apr; 54 (4): 313-321. https://doi.org/10.1001/archpsyc.1997.01830160031005
  4. Bernandt MW, Murray RM. Psychiatric disorder, drinking and alcoholism: what are the links? . Br J Psychiatr 1986 Apr; 148: 393 - 400. https://doi.org/10.1192/bjp.148.4.393
  5. Weiss RD, Mirin SM. Substance abuse as an attempt at self-medication. Psychiatric Med 1987; 3: 357 - 367.      
  6. Morrison JR. Bipolar affective disorder and alcoholism. Am J Psychiatr 1974 Oct; 131 (10): 1130 - 1133. https://doi.org/10.1176/ajp.131.10.1130
  7. Kaworski F, Dubertret C, Adès J, Gorwood P. Presence of co-morbid substance use disorder in bipolar patients worsens their social functioning to the level observed in patients with schizophrenia. Psychiatry Res 2011 Jan 30; 185 (1-2): 129-34. https://doi.org/10.1016/j.psychres.2010.06.005
  8. Hawton K, Sutton L, Haw C, Sinclair J, Harriss L. Suicide and attempted suicide in bipolar disorder: a systematic review of risk factors. J Clin Psychiatry 2005; Jun; 66 (6): 693-704. https://doi.org/10.4088/jcp.v66n0604
  9. Oquendo MA, Currier D, Liu SM, Hasin DS, Grant BF, Blanco C. Increased risk for suicidal behaviour in comorbid bipolar disorder and alcohol use disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). J Clin Psychiatry 2010 Jul; 71 (7): 902-9. https://doi.org/10.4088/jcp.09m05198gry
  10. Weiss RD, Najavits IM. Overview of treatment modalities for dual diagnosis patients: pharmacotherapy, psychotherapy and 12-step programs. In: Dual Diagnosis and Treatment: Substance Abuse and Comorbid Medical and Psychiatric Disorders. Xiii ed. New York: Marcel Dekker 1998; 107-137. https://doi.org/10.3109/9780203017616-10
  11. Grech G, Grech A. The Maltese Experience. In: Comorbidity; Perspectives Across Europe. Baldacchino A, Corkery J (eds.) European Collaborating Centres in Addiction Studies; 2006. p199-207.