Substance use disorders in bipolar disorders: Clinical correlates and treatment response to mood stabilizers

Menculini, Giulia; Steardo, Luca; Verdolini, Norma; Cirimbilli, Federica; Moretti, Patrizia; Tortorella, Alfonso

doi:10.1016/j.jad.2022.01.001

Cited by 8 publications

(8 citation statements)

References 88 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Lastly, our data revealed no difference in SUD between BD type I and II. This is in contrast with previous clinical ( 26 , 35 , 62 ) and epidemiological studies, reporting an increased prevalence of SUD in BD type I ( 20 , 24 ). No association between polySUD and current or lifetime suicidal behaviors was found in the multinomial regression analysis, although this significant relationship has been reported in a recent meta-analysis ( 28 ).…”

Section: Discussioncontrasting

confidence: 99%

“…Regarding clinical variables, earlier age at onset, the presence of psychotic and residual symptoms, and a family history positive for psychiatric disorders were found to be significantly associated with polySUD in patients with BD. These findings are in line with other studies ( 35 , 37 , 44 ). Illicit substances are considered to be one of the main risk factors and triggers for bipolar illness, as defined by the new diagnostic category named “substance-induced bipolar and related disorder” in the DSM-5 ( 1 ).…”

Section: Discussionsupporting

confidence: 94%

“…The present paper aimed to evaluate the factors associated with SUD and polySUD in a cohort of patients with BD. Evidence from epidemiological, clinical, and review studies has shown that the comorbidity between patients with a primary diagnosis of BD and SUD is frequent ( 23 , 27 , 28 , 35 ). This has also been confirmed in our sample.…”

Section: Discussionmentioning

confidence: 99%

“…Family history of psychiatric disorders has been reported to be a predictor of polySUD in patients with a primary diagnosis of BD, suggesting a vulnerability for this comorbidity ( 35 , 58 , 59 ). Indeed, our results have shown an increase in inpatient involuntary admissions of BD patients with SUD, in line with previous studies ( 60 , 61 ).…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Bipolar Disorder and Polysubstance Use Disorder: Sociodemographic and Clinical Correlates

Aguglia

Natale²,

Fusar-Poli³

et al. 2022

Front. Psychiatry

View full text Add to dashboard Cite

IntroductionPatients with bipolar disorder (BD) often show comorbidity with substance use disorder (SUD) with a negative impact on clinical course, prognosis, and functioning. The role of polysubstance use disorder (polySUD) is understudied. The aim of the present paper is to evaluate the sociodemographic and clinical characteristics associated with BD and comorbid SUD, focusing on polySUD, in order to phenotype this specific group of patients and implement adequate treatment and prevention strategies.MethodsA cross-sectional study was conducted involving 556 patients with a primary diagnosis of BD (376 without SUD, 101 with SUD, and 79 with polySUD). A semi-structured interview was administered to collect sociodemographic variables, clinical characteristics, and pharmacological treatment. ANOVA and chi-square tests were used to compare the three groups. Significantly different variables were then inserted in multivariate logistic regression.ResultsPatients affected by BD and polySUD were younger, and more frequently males and single, than patients with SUD or without SUD. Indeed, the prevalence of patients affected by BD and polySUD living in residential facilities was higher than in the other groups. Moreover, earlier age at onset, higher prevalence of psychotic and residual symptoms, involuntary hospitalization, and a family history of psychiatric disorders were associated with polySUD in patients suffering from BD. Lastly, patients with BD and polySUD were more likely to take four or more medications, particularly benzodiazepines and other drugs. At the multinomial regression, younger age, male gender, early age at onset, psychotic and residual symptoms, positive family history of psychiatric disorders, and use of benzodiazepines remained significantly associated with polySUD in patients with BD.ConclusionOur findings show a specific profile of patients with BD and polySUD. It is important to conduct research on this topic in order to adopt specific therapeutic strategies, minimize the use of polypharmacy, and aim at full remission and mood stabilization.

show abstract

Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Bipolar Disorder and Polysubstance Use Disorder: Sociodemographic and Clinical Correlates

Aguglia

Natale²,

Fusar-Poli³

et al. 2022

Front. Psychiatry

View full text Add to dashboard Cite

show abstract

“…This could also explain higher rates of mood stabilizer prescription in the sample, even though the diagnosis of bipolar disorders did not significantly change. To this extent, it should be noted that the emergence of SUD or anxiety symptoms during youth may be the expression of a bipolar diathesis in young people, and this may partially explain the higher mood stabilizer prescription rate ( 73 ). Furthermore, we should consider that adjustment disorders may also manifest with disturbed conduct, which may more frequently benefit from mood stabilizers or antipsychotics in youths ( 74 , 75 ).…”

Section: Discussionmentioning

confidence: 99%

COVID-19 and Youth Psychopathological Distress in Umbria, Central Italy: A 2-Year Observational Study in a Real-World Setting

et al. 2022

Self Cite

View full text Add to dashboard Cite

IntroductionAdolescents and young adults represent a vulnerable population in the context of the Coronavirus disease 2019 (COVID-19) pandemic. The present retrospective study aims to investigate the pandemic’s psychological impact on adolescents and young adults by analyzing data from an outpatient mental health service dedicated to youths in Umbria, central Italy.Materials and MethodsThe clinical charts of subjects aged 14–24 who first accessed the service in the timeframe between March 1st, 2019, and February 28th, 2021, were reviewed. Subjects were divided into two subgroups according to the period of time when they accessed the service (pre-COVID-19 vs. during- COVID-19 outbreak). Bivariate analyses were performed using the Chi-square test and the Welch’s t-test. A secondary analysis was performed considering only subjects suffering from psychiatric disorders. Furthermore, data concerning individuals who were already followed by the service before the pandemic were analyzed by the McNemar’s test and the t-paired test to assess changes in treatment features.ResultsThe number of new accesses during the pandemic period remained stable. After the emergency onset, youths accessing the service showed a higher prevalence of anxiety disorders (p = 0.022). During the COVID-19 period, services were more frequently delivered by using a digital mental health approach (p = 0.001). Psychopharmacological treatment was more frequently prescribed among subjects that were referred to the service after the pandemic onset (p = 0.033). As for substance use, a highly significant reduction in opioid use was observed (p = 0.003). Family therapy was delivered less frequently in the during-COVID-19 subgroup, especially in the subpopulation of subjects suffering from psychiatric disorders (p = 0.013). When considering subjects referred to the service in the pre-COVID-19 period, the number of interventions provided to this population increased after the pandemic outbreak (p = 0.038).ConclusionIn the context of the COVID-19-related public health crisis, youths represent an at-risk population for which pathways to care should be reinforced, and targeted interventions, including psychosocial treatments, should be implemented.

show abstract

Synthesising 30 years of clinical experience and scientific insight on affective temperaments in psychiatric disorders: State of the art

Favaretto,

Bedani,

Brancati

et al. 2024

Journal of Affective Disorders

View full text Add to dashboard Cite

Substance use disorders in bipolar disorders: Clinical correlates and treatment response to mood stabilizers

Cited by 8 publications

References 88 publications

Bipolar Disorder and Polysubstance Use Disorder: Sociodemographic and Clinical Correlates

Bipolar Disorder and Polysubstance Use Disorder: Sociodemographic and Clinical Correlates

COVID-19 and Youth Psychopathological Distress in Umbria, Central Italy: A 2-Year Observational Study in a Real-World Setting

Synthesising 30 years of clinical experience and scientific insight on affective temperaments in psychiatric disorders: State of the art

Contact Info

Product

Resources

About