Study Links Bipolar Disorder to Substance Abuse

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A recent study in the Journal of the American Academy of Child and Adolescent Psychiatry links bipolar disorder in teens to first-time drug abuse.

The study shows that within four years of follow-up, one in three teens with the condition became a drug user or developed substance abuse. The study participants were 167 youths, ages 12 to 17, who had been identified previously as bipolar.

Predicting risk for bipolar disorder

Although a four-year time frame was the end point, the average time to first substance abuse was 2.7 years. The significance of this metric is that it can be used as a predictor of risk, allowing caregivers to focus on substance abuse in this type of patient. The study included alcohol as an abused substance, and experiments with alcohol at the beginning of the study was the best indicator of abuse later, although researchers reported that use of cannabis was also highly predictive.

Note that “abuse” in this context is defined as more than just using or experimenting with a drug or alcohol. To qualify as abuse, a patient has to show some social or physical problem that stems from consumption. So someone who merely tries marijuana or alcohol on occasion is not considered an “abuser.” Using this higher standard teases out the more harmful outcomes from “social” contact with drugs and alcohol.

Other factors which had some predictive power were:

  • Panic disorder
  • Family history of substance abuse
  • Oppositional defiant disorder
  • Poor family structure
  • No antidepressant treatment

Though these factors have a high likelihood of leading to substance abuse, some of them are more difficult to treat, especially poor family structure and defiant disorder.

One critical outcome is that preventing initial experimentation by limiting access may reduce the risk of subsequent harm. The study did not show which type of intervention, if any, would help prevent later substance abuse. Prediction is a powerful tool, but it has to be coupled with useful treatments to yield positive outcomes. In today’s world, is it possible to prevent early experimentation with drugs or alcohol? A key question.

Source: Medical News Today

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