Study details risk factors for substance use disorders after manic episode

July 22, 2014 by Keith Herrell, University of Cincinnati

(Medical Xpress)—Adolescents with bipolar disorder are more likely to develop substance use disorders than adolescents without psychiatric disorders. Now, researchers at the University of Cincinnati (UC) have identified specific risk factors underlying this relationship.

The researchers, led by Melissa DelBello, MD, the Dr. Stanley and Mickey Kaplan Chair of Psychiatry and Behavioral Neuroscience, publish their findings in the July issue of the Journal of Child & Adolescent Psychiatry. DelBello is the senior author.

The researchers studied 103 adolescents between 12 and 20 years old who were diagnosed with bipolar I disorder and hospitalized for the first time for a manic episode. Of those 103 adolescents, 32 were already diagnosed with a substance use disorder at the time of hospitalization.

Of the 71 participants who did not have a substance use disorder at hospitalization, 17 (24 percent) developed a substance use disorder during follow-up, ranging from 17 weeks to 283 weeks. The most common substance use disorders were alcohol abuse or dependence, (13 of the 17 participants), followed by cannabis abuse or dependence (12 participants). (Some participants developed substance use disorders involving both cannabis and alcohol.)

Participants who developed a substance use disorder had significantly later age of onset of than those who did not (14.4 years vs. 12.1 years). Psychosis at baseline was significantly associated with developing a substance abuse disorder. In addition, comorbid disruptive behavior disorders and post-traumatic stress disorders (PTSD) were significantly associated with developing a substance use disorder during follow-up.

Conversely, treatment with stimulants before the onset of bipolar disorder was significantly associated with not developing a substance use disorder during follow-up.

"Our analyses revealed several risk factors that were associated with developing a new substance use disorder after the first manic episode in adolescence," says DelBello. "Psychosis and PTSD showed the strongest evidence of predicting a new-onset substance use disorder."

DelBello notes that self-medication could be a prominent reason for developing a substance use disorder after the onset of bipolar disorder. Additionally, the impulsivity associated with mania might contribute to developing a substance use disorder.

DelBello also noted that participants who had been prescribed stimulants before the index episodes had roughly one-fourth the risk for developing a substance use disorders.

"One explanation for this is that the stimulants were effectively treating ADHD, which has been shown to minimize risk for developing a substance use disorder," she says.

DelBello says the study offers several clinical insights, including:

  • Adolescents with bipolar disorder have a particularly high risk of developing a .
  • Substance use should be closely monitored in adolescents with bipolar disorder, and clinicians should advise adolescents with bipolar disorder and their parents about the risk of developing substance use disorders and the associated poor outcomes.
  • In particular, close attention should be given to with bipolar disorder who have experienced trauma (mental or physical) and/or who have psychotic symptoms.

Explore further: Predictors of substance abuse identified among teens with bipolar disorder

Related Stories

Predictors of substance abuse identified among teens with bipolar disorder

October 2, 2013
A study published in the October 2013 issue of the Journal of the American Academy of Child and Adolescent Psychiatry found that approximately one in three teens with bipolar disorder developed substance abuse, for the first ...

High rates of substance abuse exist among veterans with mental illness

April 19, 2011
A new study published in The American Journal on Addictions reveals that Veterans who suffer from mental health disorders also have high rates of substance use disorders.

Trial examines mindfulness-based cognitive therapy's effect on anxiety

April 16, 2014
Faculty members at the University of Cincinnati (UC) College of Medicine will collaborate on a clinical trial designed to gauge the effectiveness of mindfulness-based cognitive therapy on children and adolescents with anxiety ...

Long-term study data supports association between childhood ADHD and substance abuse risk

May 31, 2011
Analysis of data from two long-term studies of the impact of attention-deficit hyperactivity disorder (ADHD) on the development of psychiatric disorders in young adults confirms that ADHD alone significantly increases the ...

Children with ADHD prone to substance use disorders

July 1, 2014
(HealthDay)—Screening for substance use disorders (SUDs) and the safe use of stimulant medications are important issues in the care of children with attention-deficit/hyperactivity disorder (ADHD), according to research ...

Recommended for you

Intensive behavior therapy no better than conventional support in treating teenagers with antisocial behavior

January 19, 2018
Research led by UCL has found that intensive and costly multisystemic therapy is no better than conventional therapy in treating teenagers with moderate to severe antisocial behaviour.

Babies' babbling betters brains, language

January 18, 2018
Babies are adept at getting what they need - including an education. New research shows that babies organize mothers' verbal responses, which promotes more effective language instruction, and infant babbling is the key.

College branding makes beer more salient to underage students

January 18, 2018
In recent years, major beer companies have tried to capitalize on the salience of students' university affiliations, unveiling marketing campaigns and products—such as "fan cans," store displays, and billboard ads—that ...

Inherited IQ can increase in early childhood

January 18, 2018
When it comes to intelligence, environment and education matter – more than we think.

Modulating molecules: Study shows oxytocin helps the brain to modulate social signals

January 17, 2018
Between sights, sounds, smells and other senses, the brain is flooded with stimuli on a moment-to-moment basis. How can it sort through the flood of information to decide what is important and what can be relegated to the ...

Baby brains help infants figure it out before they try it out

January 17, 2018
Babies often amaze their parents when they seemingly learn new skills overnight—how to walk, for example. But their brains were probably prepping for those tasks long before their first steps occurred, according to researchers.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.