Bipolar spectrum and drug addiction

Abstract

I read with interest the article by Maremmani et al. (2006) in which it was hypothesized that drug addiction can be regarded as part of the “bipolar spectrum”. I totally agree with this assumption and to endorse it I would like to cite a publication of many years ago (Altamura, 1975) that unexpectedly was not considered among the references of your paper. In that article, I reported in young heroin addicts (the first observation made in the Milan area during 1973– 1974 in hospitalized patients, when the phenomenon was sporadic and not epidemic as subsequently in Italian metropolitan areas and the weight of “social” correlates was much less evident) that the majority of the subjects presented signs of bipolarity and/or a positive family history for bipolar disorders. The description of the personal history of these patients can today “tout court” be regarded as part of bipolar spectrum. At that time “masked depression” was a fashionable topic and I suggested that drug addiction can be part of it. Much less or no evidence was given to hypomania or sub-clinical signs of bipolarity and of course the concept of bipolar depression was not available in those days. The paper actually focused on the possibility of using lithium as therapy and methadone was not a treatment of choice for these addictions. Mogen Schou personally encouraged me to making this clinical report during my stay for fewmonths inAarhus as visiting scientist in 1974.