Monday, August 2, 2010

Bipolar disorder and substance abuse

Bryan K. Tolliver, MD, PhD,
Assistant professor, Clinical neuroscience division, Department of psychiatry and behavioral sciences, Medical University of South Carolina, Charleston, SC

The high prevalence of substance use disorders (SUDs) in persons with bipolar disorder (BD) is well documented. Up to 60% of bipolar patients develop an SUD at some point in their lives. Alcohol use disorders are particularly common among BD patients, with a lifetime prevalence of roughly 50%. Recent epidemiologic data indicate that 38% of persons with bipolar I disorder and 19% of those with bipolar II disorder meet criteria for alcohol dependence. Comorbid SUDs in patients with BD are associated with:
  • poor treatment compliance
  • longer and more frequent mood episodes
  • more mixed episodes
  • more hospitalizations
  • more frequent suicide attempts.
The impact of co-occurring SUDs on suicidality is particularly high among those with bipolar I disorder. Frequently referred to as “dual diagnosis” conditions, co-occurring BD and SUDs may be more accurately envisioned as multi-morbid, rather than comorbid, illnesses.

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1 comment:

  1. The term "poor treatment compliance" implies that the treatment plan is imposed on a person from outside. In the new language of recovery a "person driven plan" makes the term "treatment compliance" obsolete.

    As far as substance use I used both alcohol and stimulants (not together) to accentuate hypo-mania. Sometimes I drink when I’m bored but I rarely use anything when I’m depressed because it just makes it worse.