Risk of substance use disorders in adolescents with bipolar disorder.
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.
Wilens
Timothy E
TE
Pediatric Psychopharmacology Unit, Child Psychiatric Service, Massachusetts General Hospital, and Harvard Medical School, Boston, MA 02114, USA. twilens@partners.org
Biederman
Joseph
J
Kwon
Anne
A
Ditterline
Jeffrey
J
Forkner
Peter
P
Moore
Hadley
H
Swezey
Allison
A
Snyder
Lindsey
L
Henin
Aude
A
Wozniak
Janet
J
Faraone
Stephen V
SV
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*