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08/07/2008 - Teens with Bipolar Disorder at "Huge" Risk for Substance Abuse Disorder
A June article in "Drug and Alcohol Dependence" supported previous research that adolescents with bipolar disorder are at increased risk for substance abuse. A study done at Massachusetts General Hospital confirmed that bipolar disorder is a "huge" risk factor for substance abuse.
In fact, Timothy Wilens, M.D., director of Substance Abuse Services at MGH who led the study, said bipolar disorder was "as big a risk factor as juvenile delinquency" for occurrence of substance abuse in teens.
The study looked at 105 subjects with bipolar disorder and 98 controls age 10 to 18. Subjects with bipolar disorder had a significantly higher age-adjusted rate of substance-use disorder and cigarette smoking compared to control subjects. More than two-thirds with co-occurring disorders experienced onset of bipolar disorder before onset of substance use disorder. There were no significant differences in age between adolescents with bipolar disorder and control subjects, and no differences in sex or family intactness.
The idea of co-occurring mental illnesses and addiction disorders is not new. Alcohol and drug abuse disorders are highly common among those with mental disorders.
According to reports published in the Journal of the American Medical Association (JAMA), some 50 percent of individuals with sever mental disorders are affected by substance abuse. Nearly 40 percent of alcohol abusers and 53 percent of drug abusers also have at least one serious mental illness.
Physicians say they are increasingly seeing patients from all walks of life that suffer from a combination of substance abuse and mental health problems. Many factors may contribute to the comorbidity of mental disorders and substance use disorders, including self-medication of symptoms, mood symptoms either brought on or perpetuated by substance abuse, and risk factors that may influence the occurrence of both bipolar disorder and substance use disorders.
The importance of this study is that it indicates that young people with bipolar disorder need to be carefully screened for substance abuse. Additionally, adolescents known to abuse drugs and alcohol, especially those that display binge use, should be assessed for bipolar disorders.
Beyond this study, diagnosis and treatment for substance abuse and addictive disorders is critical for those with mental disorders, as they frequently co-occur and typically have a negative impact on each other.
Knowing the high incidence of comorbid mental disorders/ substance abuse disorders, as well as focusing on ways to diagnose and treat co-occurring illnesses, could have an enormous impact on successful treatment of these patients.