Untreated bipolar heightens risk of substance use disorder

There’s yet more evidence of the link between bipolar disorder and substance abuse.

Researchers from Massachusetts General Hospital had already shown a clear association between bipolar in teenagers and the use of cigarettes and other drugs but now a follow-up study has widened the picture.

The team went back and looked at their same study subjects five years on.

“Those originally diagnosed with bipolar disorder who continued to have symptoms five years later were at an even higher risk for cigarette smoking and substance use disorder than those whose symptoms were reduced either because of remission from bipolar disorder or from treatment,” says study author, Dr Timothy Wilens.

The original study, published in 2008, looked at 105 teenagers diagnosed with bipolar disorder and 98 with no mood disorders. The average age of participants was 14.

The rate of substance use among those with bipolar was 34 percent, while it was only four per cent in the other group. The risk for smoking was 22 percent for those with bipolar and four per cent for the control group.

Five years on, more members of the bipolar group developed new cases of substance use disorder, leading to an overall incidence rate of 49 percent verses 26 percent.

“Since symptoms of bipolar disorder usually appear before substance use disorder develops, clinicians following youth with bipolar disorder should carefully monitor for cigarette smoking and substance use, along with treating bipolar symptoms,” says Dr Wilens.

His team is now analysing brain imaging of some of the participants to try to understand the circuitry involved in the disorders and their interaction.