Substance Abuse in First-Episode Bipolar I Disorder: Indications for Early Intervention

• Published in: The American journal of psychiatry Vol. 162; no. 5; pp. 1008 - 1010
• Main Authors: Baethge, Christopher, Baldessarini, Ross J., Khalsa, Hari-Mandir Kaur, Hennen, John, Salvatore, Paola, Tohen, Mauricio
• Format: Journal Article
• Language: English
• Published: Washington, DC American Psychiatric Publishing 01.05.2005; American Psychiatric Association
• Subjects: Addictive behaviors; Adult; Adult and adolescent clinical studies; Alcoholism; Anxiety Disorders - diagnosis; Anxiety Disorders - epidemiology; Anxiety Disorders - therapy; Biological and medical sciences; Bipolar disorder; Bipolar Disorder - diagnosis; Bipolar Disorder - epidemiology; Bipolar Disorder - therapy; Bipolar disorders; Clinical outcomes; Comorbidity; Depression; Diagnosis, Dual (Psychiatry); Diagnostic and Statistical Manual of Mental Disorders; Drug addiction; Early intervention; Female; Health risk assessment; Humans; Male; Medical sciences; Mood disorders; Outcome Assessment (Health Care); Patients; Prevalence; Psychiatric Status Rating Scales; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Solvent abuse; Substance-Related Disorders - diagnosis; Substance-Related Disorders - epidemiology; Substance-Related Disorders - therapy; Mood disorder; Human; Drug addiction; Alcoholism; Anxiety disorder; Depression; Bipolar disorder; Cannabidaceae; Substance abuse; Concomitant disease; Cannabis; Treatment; First episode; Dicotyledones; Angiospermae; Mania; Spermatophyta
• ISSN: 0002-953X; 1535-7228
• DOI: 10.1176/appi.ajp.162.5.1008

OBJECTIVE: This study clarified the early characteristics of substance use disorders in patients with first-episode bipolar I disorder. METHOD: The authors evaluated substance use disorders, associated factors, and clinical course, prospectively, in the first 2 years of DSM-IV bipolar I disorder with standardized methods. RESULTS: Baseline substance use disorder was found in 33% (37 of 112) of the patients at baseline and in 39% at 24 months. Anxiety disorders were more frequent in the patients with than without substance use disorder (30% and 13%, respectively). Associations of alcohol dependence with depressive symptoms and cannabis dependence with manic symptoms were suggested. Patients using two or more substances had worse outcomes. CONCLUSIONS: Since substance use disorders were frequent from the beginning of bipolar I disorder and were associated with anxiety disorders and poor outcome, early interventions for substance use disorder and anxiety might improve later outcome.