The impact of mood symptomatology on pattern of substance use among homeless.
BACKGROUND
Homeless individuals are an extremely vulnerable and underserved population characterized by overlapping problems of mental illness and substance use. Given the fact that mood disorders are frequently associated with substance use disorders, we wanted to further highlight the role of excitement in substance abuse. Patterns of substance abuse among homeless suffering from unipolar and bipolar depression were compared. The "self-medication hypothesis" which would predict no-differences in substance preference by unipolar (UP) and bipolar (BP) depressed homeless was tested.


METHODS
Homeless individuals from the Vancouver At Home/Chez Soi study were selected for lifetime UP and lifetime BP depression and patterns of substances abused in the previous 12 months were identified with the Mini-International Neuropsychiatric Interview. Differences in substance use between BP-depressed homeless and UP-depressed homeless were tested using Chi-square and logistic regression techniques.


RESULTS
No significant differences were observed between UP and BP homeless demographics. The bipolar depressed homeless (BDH) group displayed a higher percentage of Central Nervous System (CNS) Stimulants (χ 8.66, p=0.004) and Opiates (χ 6.41, p=0.013) as compared to the unipolar depressed homeless (UDH) group. CSN Stimulant was the only predictor within the BDH Group (χ(2) 8.74 df 1 p<0.003).


CONCLUSIONS
Data collected are self-reported and no urinalyses were performed.


CONCLUSIONS
The results support the hypothesis that beyond the self-medication hypothesis, bipolarity is strictly correlated to substance use; this correlation is also verified in a homeless population.
"Vincent P. Dole" Dual Diagnosis Unit, Department of Clinical and Experimental Medicine, University of Pisa, Italy; Association for the Application of Neuroscientific Knowledge to Social Aims (AU-CNS), Pietrasanta, Lucca, Italy. Electronic address: angelogimaremmani@gmail.com.
Angelo Giovanni Icro
AG
Maremmani
"Vincent P. Dole" Dual Diagnosis Unit, Department of Clinical and Experimental Medicine, University of Pisa, Italy.
Silvia
S
Bacciardi
Centre for Health Evaluation and Outcome Sciences, St. Paul׳s Hospital, Vancouver, BC, Canada; School of Population and Public Health, University of British Columbia, Canada; Institute of Mental Health, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
Nicole D
ND
Gehring
University of Bicocca, Milan, Italy.
Luca
L
Cambioli
Institute of Mental Health, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada; Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
Christian
C
Schütz
International Mood Centre, University of California and Veterans Administration Hospital, San Diego, California, USA.
Hagop S
HS
Akiskal
Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
Kerry
K
Jang
Centre for Health Evaluation and Outcome Sciences, St. Paul׳s Hospital, Vancouver, BC, Canada; School of Population and Public Health, University of British Columbia, Canada; Institute of Mental Health, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada; Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
Michael
M
Krausz
D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology*; D002170:Canada / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006703:Ill-Housed Persons / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011619:Psychotropic Drugs / Q000008:administration & dosage*; D012651:Self Medication / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology*; D055815:Young Adult
D011619:Psychotropic Drugs
Bipolar depression; Homeless; Mood disorder; Self-medication; Substance use; Unipolar depression