The spectrum of substance abuse in bipolar disorder: reasons for use, sensation seeking and substance sensitivity.
OBJECTIVE
To examine the spectrum of alcohol and substance abuse, including reasons for use, in patients with bipolar I disorder, compared with patients with substance use disorder and healthy controls, with a specific focus on the relationship between substance use, substance sensitivity, other comorbid psychiatric symptoms and traits related to sensation seeking.


METHODS
This study included 104 patients with bipolar I disorder (BPD I), of whom 57 (54.8%) met DSM-IV criteria for lifetime alcohol or substance use disorder (BPD + SUD), 35 patients with substance use disorder (SUD) and no psychiatric disorder and 50 healthy controls. Assessments included the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) and the Structured Clinical Interview for the Spectrum of Substance Use (SCI-SUBS).


RESULTS
Patients with BPD + SUD and SUD had significantly higher scores on the SCI-SUBS domains of self-medication, substance sensitivity and sensation seeking compared with patients with BPD and healthy controls. Reasons for substance use did not differ between patients with BPD + SUD and patients with SUD. Those most frequently cited were: improving mood; relieving tension; alleviating boredom; achieving/maintaining euphoria; and increasing energy.


CONCLUSIONS
Recourse to substances is associated with increased mood and anxiety symptoms, substance sensitivity, and sensation seeking among patients with BPD + SUD and SUD. Substance sensitivity and sensation seeking traits should be investigated in all patients with BPD as possible factors associated with a development of SUD, in order to warn patients of the specific risks related to improper use of medications and substances.
Bizzarri
Jacopo V
JV
Drug Addiction Service, Bolzano, Italy.
Sbrana
Alfredo
A
Rucci
Paola
P
Ravani
Laura
L
Massei
Guido Jacopo
GJ
Gonnelli
Chiara
C
Spagnolli
Sabrina
S
Doria
Maria Rosa
MR
Raimondi
Federica
F
Endicott
Jean
J
Dell'Osso
Liliana
L
Cassano
Giovanni Battista
GB
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D001887:Boredom; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005106:Exploratory Behavior; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012651:Self Medication / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology*
D014150:Antipsychotic Agents