title: Are "social drugs" (tobacco, coffee and chocolate) related to the bipolar spectrum?
abstract: BACKGROUND
  Across all ages and cultures, mankind has always used substances in order to induce pleasurable sensations or desirable psychophysical states. These substances, notably caffeine, tobacco, alcohol and chocolate, can be labeled 'social drugs'.
  
  
  METHODS
  We analyzed the social drug habits of 562 patients suffering from mood disorders, according to DSM-IV-R criteria (major depressive episode, recurrent depression, bipolar type I and II disorders and depression not otherwise specified). The sample was also divided into bipolar and non-bipolar according to Hypomania Check-list 32 (HCL-32), which proposes a broader concept of hypomania and soft bipolarity, comprising the spectrum of bipolar disorders proper, along with other, "softer" expressions of bipolarity intermediate between bipolar disorder and normality.
  
  
  RESULTS
  Using HCL-32 criteria, but DSM-IV-R criteria, a link was confirmed between bipolar spectrum and substance use including social drugs such as tobacco and coffee.
  
  
  CONCLUSIONS
  Observational correlational study.
  
  
  CONCLUSIONS
  This study is in support of earlier theoretical formulations within the framework of the Pisa-San Diego collaboration.
authors: Department of Psychiatry, University of Pisa and G. De Lisio Institute of Behavioural Sciences, Pisa, Italy. maremman@med.unipi.it
authors: Icro
authors: I
authors: Maremmani
authors: Giulio
authors: G
authors: Perugi
authors: Luca
authors: L
authors: Rovai
authors: Angelo Giovanni Icro
authors: AG
authors: Maremmani
authors: Matteo
authors: M
authors: Pacini
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authors: P
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authors: C
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