title: Risk of substance use disorders in adolescents with bipolar disorder.
abstract: OBJECTIVE
  Previous work in adults and youths has suggested that juvenile onset bipolar disorder (BPD) is associated with an elevated risk of substance use disorders (SUD). Considering the public health importance of this issue, the authors now report on a controlled study of adolescents with and without BPD to evaluate the risk of SUD.
  
  
  METHODS
  Probands with DSM-IV BPD (n=57, mean age +/- SD=13.3 +/- 2.4 years) and without DSM-IV BPD (n=46, 13.6 +/- 2.2 years) were studied. Structured psychiatric interviews and multiple measures of SUD were collected.
  
  
  RESULTS
  Bipolar disorder was associated with a highly significant risk factor for SUD (32% versus 7%, Z=2.9, p=.004) that was not accounted for by conduct disorder (adjusted odds ratio=5.4, p=.018). Adolescent-onset BPD (> or =13 years) was associated with a higher risk of SUD compared with those with child-onset BPD (chi1=9.3, p=.002).
  
  
  CONCLUSIONS
  These findings strongly indicate that BPD, especially adolescent onset, is a significant risk factor for SUD independently of conduct disorder.
authors.affiliation: Pediatric Psychopharmacology Unit, Child Psychiatric Service, Massachusetts General Hospital, and Harvard Medical School, Boston, MA 02114, USA. twilens@partners.org
authors.forename: Timothy E
authors.initials: TE
authors.lastname: Wilens
authors.forename: Joseph
authors.initials: J
authors.lastname: Biederman
authors.forename: Anne
authors.initials: A
authors.lastname: Kwon
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Ditterline
authors.forename: Peter
authors.initials: P
authors.lastname: Forkner
authors.forename: Hadley
authors.initials: H
authors.lastname: Moore
authors.forename: Allison
authors.initials: A
authors.lastname: Swezey
authors.forename: Lindsey
authors.initials: L
authors.lastname: Snyder
authors.forename: Aude
authors.initials: A
authors.lastname: Henin
authors.forename: Janet
authors.initials: J
authors.lastname: Wozniak
authors.forename: Stephen V
authors.initials: SV
authors.lastname: Faraone
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D001714:Bipolar Disorder / Q000150:complications* / Q000523:psychology*; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000209:etiology* / Q000523:psychology*