Substance abuse in first-episode bipolar I disorder: indications for early intervention

Am J Psychiatry. 2005 May;162(5):1008-10. 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.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / therapy
  • Bipolar Disorder / diagnosis
  • Bipolar Disorder / epidemiology*
  • Bipolar Disorder / therapy
  • Comorbidity
  • Diagnosis, Dual (Psychiatry)
  • Diagnostic and Statistical Manual of Mental Disorders
  • Female
  • Humans
  • Male
  • Outcome Assessment, Health Care
  • Prevalence
  • Psychiatric Status Rating Scales
  • Substance-Related Disorders / diagnosis
  • Substance-Related Disorders / epidemiology*
  • Substance-Related Disorders / therapy