Impact of substance abuse on the course and treatment of bipolar disorder

Abstract

Comorbidity of bipolar disorder and alcoholism and other PSUDs is highly prevalent. The presence of this so called 'dual diagnoses' creates a serious challenge in terms of establishing an accurate diagnosis and providing appropriate treatment interventions. The inter-relationship between these disorders appears to be mutually detrimental. The course, manifestation, and treatment of each condition are significantly compounded by the presence of the other condition. Substance abuse and alcoholism appear to significantly complicate the course and prognosis of bipolar disorder resulting in increased suffering, disability, and costs. On the other hand, bipolar disorder may be a risk factor for developing PSUDs. Although, there are a number of hypotheses explaining the pathophysiological mechanism involved in such comorbidities, our understanding of the exact nature of such neurobiological mechanisms is still limited. While the antikindling agents and targeted psychotherapeutic techniques may be useful intervention strategies, there is still a significant lack of empirically based treatment options for these patients.

Psychoactive substance use among outpatients with severe mental illness: A comparative study

“…The age of onset of illness was not significantly related to the lifetime and current use of any psychoactive substance investigated in this study among respondents with a diagnosis of schizophrenia and BD. This is contrary to what has been reported in previous studies, 17,18,34 where it was reported that substance use was associated with age of onset in both schizophrenia and BD. This difference may be because of methodological differences; for example, the population cohort in the earlier studies included inpatients, who were not investigated in this study, as well as community dwelling respondents.…”

Psychoactive substance use among outpatients with severe mental illness: A comparative study

“…The age of onset of illness was not significantly related to the lifetime and current use of any psychoactive substance investigated in this study among respondents with a diagnosis of schizophrenia and BD. This is contrary to what has been reported in previous studies, 17,18,34 where it was reported that substance use was associated with age of onset in both schizophrenia and BD. This difference may be because of methodological differences; for example, the population cohort in the earlier studies included inpatients, who were not investigated in this study, as well as community dwelling respondents.…”

Progression of female reproductive stages associated with bipolar illness exacerbation

“…Although previous studies have found that alcohol or substance use disorders were associated with worse mood course in bipolar disorder (43–46), in our subjects, the rates of current alcohol/substance use disorders were low and did not differ significantly between the three reproductive groups. Alcohol or substance use is an unlikely contributor to our observed mood worsening with progression toward later female reproductive life.…”

Relationship of Comorbid Substance and Alcohol Use Disorders to Disability among Patients in Routine Psychiatric Practice

“…In particular, the rates of disability and functional impairment were very high for patients with depression or bipolar disorder who also had a comorbid alcohol or other substance use disorder, as compared to those with depression or bipolar disorder alone. These findings are in line with previous research that found that patients with comorbid mental and alcohol or other substance use disorders were more likely to be work disabled than those with a single mental disorder 12 …”

Psychoactive substance use among outpatients with severe mental illness: A comparative study

“…The age of onset of illness was not significantly related to the lifetime and current use of any psychoactive substance investigated in this study among respondents with a diagnosis of schizophrenia and BD. This is contrary to what has been reported in previous studies, 17,18,34 where it was reported that substance use was associated with age of onset in both schizophrenia and BD. This difference may be because of methodological differences; for example, the population cohort in the earlier studies included inpatients, who were not investigated in this study, as well as community dwelling respondents.…”

Progression of female reproductive stages associated with bipolar illness exacerbation

“…Although previous studies have found that alcohol or substance use disorders were associated with worse mood course in bipolar disorder (43–46), in our subjects, the rates of current alcohol/substance use disorders were low and did not differ significantly between the three reproductive groups. Alcohol or substance use is an unlikely contributor to our observed mood worsening with progression toward later female reproductive life.…”

Relationship of Comorbid Substance and Alcohol Use Disorders to Disability among Patients in Routine Psychiatric Practice

“…In particular, the rates of disability and functional impairment were very high for patients with depression or bipolar disorder who also had a comorbid alcohol or other substance use disorder, as compared to those with depression or bipolar disorder alone. These findings are in line with previous research that found that patients with comorbid mental and alcohol or other substance use disorders were more likely to be work disabled than those with a single mental disorder 12 …”

Psychoactive substance use among outpatients with severe mental illness: A comparative study

“…The age of onset of illness was not significantly related to the lifetime and current use of any psychoactive substance investigated in this study among respondents with a diagnosis of schizophrenia and BD. This is contrary to what has been reported in previous studies, 17,18,34 where it was reported that substance use was associated with age of onset in both schizophrenia and BD. This difference may be because of methodological differences; for example, the population cohort in the earlier studies included inpatients, who were not investigated in this study, as well as community dwelling respondents.…”

Progression of female reproductive stages associated with bipolar illness exacerbation

“…Although previous studies have found that alcohol or substance use disorders were associated with worse mood course in bipolar disorder (43–46), in our subjects, the rates of current alcohol/substance use disorders were low and did not differ significantly between the three reproductive groups. Alcohol or substance use is an unlikely contributor to our observed mood worsening with progression toward later female reproductive life.…”

Relationship of Comorbid Substance and Alcohol Use Disorders to Disability among Patients in Routine Psychiatric Practice

“…In particular, the rates of disability and functional impairment were very high for patients with depression or bipolar disorder who also had a comorbid alcohol or other substance use disorder, as compared to those with depression or bipolar disorder alone. These findings are in line with previous research that found that patients with comorbid mental and alcohol or other substance use disorders were more likely to be work disabled than those with a single mental disorder 12 …”