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Lifetime prevalence of substance or alcohol abuse and dependence among subjects with bipolar I and II disorders in a voluntary registry

Authors

  • Kn Roy Chengappa,

    1. Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, School of Medicine;
    2. Stanley Center for the Innovative Treatment of Bipolar Disorder (also based at Western Psychiatric Institute and Clinic, University of Pittsburgh);
    3. Special Studies Center at Mayview State Hospital, a collaborative venture between Western Psychiatric Institute and Clinic and the Commonwealth of Pennsylvania
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  • Joseph Levine,

    1. Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, School of Medicine;
    2. Stanley Center for the Innovative Treatment of Bipolar Disorder (also based at Western Psychiatric Institute and Clinic, University of Pittsburgh);
    3. Special Studies Center at Mayview State Hospital, a collaborative venture between Western Psychiatric Institute and Clinic and the Commonwealth of Pennsylvania
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  • Samuel Gershon,

    1. Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, School of Medicine;
    2. Stanley Center for the Innovative Treatment of Bipolar Disorder (also based at Western Psychiatric Institute and Clinic, University of Pittsburgh);
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  • David J Kupfer

    1. Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, School of Medicine;
    2. Stanley Center for the Innovative Treatment of Bipolar Disorder (also based at Western Psychiatric Institute and Clinic, University of Pittsburgh);
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Corresponding author: K.N. Roy Chengappa, Associate Professor of Psychiatry, Western Psychiatric Institute and Clinic, Stanley Center for the Innovative Treatment of Bipolar Disorder, Special Studies Center @ Mayview State Hospital, 3811 O'Hara Street, Pittsburgh, PA 15213-2593, USA. Tel.: +1 412 624 2634; fax: +1 412 624 0493; e-mail: chengappakn@msx.upmc.edu

Abstract

Objective: To evaluate the prevalence of substance abuse dependence and/or alcohol abuse dependence among subjects with bipolar I versus bipolar II disorder in a voluntary registry.

Method: One hundred randomly selected registrants in a voluntary case registry for bipolar disorder were interviewed, using the Structured Clinical Interview for DSM-IV Axis I Disorders, to validate the diagnosis of this registry. Corroborative information was obtained from medical records, family members and the treating psychiatrist. Eighty-nine adults (18–65 years) met criteria for bipolar disorder (bipolar I=71, bipolar II=18) and were included in this analysis.

Results: Forty-one (57.8%) subjects with bipolar I disorder abused, or were dependent on one or more substances or alcohol, 28.2% abused, or were dependent on, two substances or alcohol, and 11.3% abused or were dependent on three or more substances or alcohol. Nearly 39% of bipolar II subjects abused or were dependent on one or more substances, nearly 17% were dependent on two or more substances or alcohol, and 11% were dependent on three or more substances or alcohol. Alcohol was the most commonly abused drug among either bipolar I or II subjects.

Conclusions: Consistent with other epidemiologic and hospital population studies, this voluntary bipolar disorder registry suggests a high prevalence of comorbidity with alcohol and/or substance abuse dependence. Bipolar I subjects appear to have higher rates of these comorbid conditions than bipolar II subjects; however, as the number of bipolar II subjects was rather small, this suggestion needs confirmation.

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