Impact of substance use on the physical health of patients with bipolar disorder


María P. García-Portilla, Department of Psychiatry, School of Medicine, University of Oviedo, Julián Clavería 6, 33006 Oviedo, Spain.


Garcia-Portilla MP, Saiz PA, Benabarre A, Florez G, Bascaran MT, Díaz EM, Bousoño M, Bobes J. Impact of substance use on the physical health of patients with bipolar disorder.

Objective:  To describe the impact of tobacco, alcohol and cannabis on metabolic profile and cardiovascular risk in bipolar patients.

Method:  Naturalistic, cross-sectional, multicenter Spanish study. Current use of tobacco, alcohol and cannabis was determined based on patient self-reports. Metabolic syndrome was defined using the National Health and Nutrition Examination Survey 1999–2000 and the American Heart Association/National Heart, Lung and Blood Institute criteria, and cardiovascular risk using the Framingham and the Systematic Coronary Risk Evaluation functions.

Results:  Mean age was 46.6 years, 49% were male. Substance use: 51% tobacco, 13% alcohol and 12.5% cannabis. Patients who reported consuming any substance were significantly younger and a higher proportion was male. After controlling for confounding factors, tobacco was a risk factor for coronary heart disease (CHD) (unstandardized linear regression coefficient 3.47, 95% confidence interval 1.85–5.10).

Conclusion:  Substance use, mainly tobacco, was common in bipolar patients. Tobacco use negatively impacted CHD risk.