Addiction co-morbidity in bipolar disorder

Abstract

IntroductionAddiction is often underdiagnosed in bipolar disorder (BD), although it is frequent and known to complicate its clinical course.ObjectivesThe aim of our study was to study socio-demographic and clinical factors associated with addiction in BD patients.MethodsThis is a retrospective, cross-sectional, descriptive and comparative study on 100 patients followed in our department and diagnosed with BD type I according to DSM 5. Demographic and clinical data was compared across the groups: Addiction + (A + ) and Addiction–(A − ).ResultsNighteen patients had an addiction co-morbidity (A + ), whereas 81 had not (A − ). The mean age of the (A + ) group was 39.47 years whereas it was 42.52 years in the (A − ) group. Males represented 68.4% of the (A + ) group and 48.1% of the (A − ) group. Age of illness onset was lower in the (A + ) group (mean = 23.16, median = 21) compared to the (A − ) group (mean = 26.04, median = 27). Addiction co-morbidity was significantly associated with predominant manic polarity (P = 0.03). All (A + ) patients presented mood episodes with psychotic features, whereas psychotic features were only found in 86.6% of (A − ) patients. Co-morbid addiction was significantly associated with a higher number of mood episodes (P = 0.04), a higher number and duration of hospitalisations (P = 0.02, P = 0.015), and a poorer compliance (P = 0.07). All A+ subjects received antipsychotics, and they were significantly more to receive long-acting antipsychotics (P = 0.06).ConclusionsAddictions worsen the prognosis of bipolar disorder and require specific therapeutic strategies. They deserve therefore the particular attention of clinicians.Disclosure of interestThe authors have not supplied their declaration of competing interest.