A Comparison Between Patients Diagnosed With Bipolar Disorder With Versus Without Comorbid Substance Abuse

Objectives:The purpose of the study was to compare hospitalized individuals with bipolar disorder with and without comorbid substance abuse, on demographic, hospital-related data, symptom severity, and severity change during hospitalization.Methods:Individuals who met diagnostic criteria (bipolar disorder or bipolar disorder with comorbid substance abuse) were compared on demographic variables (sex, race, and age), hospital-related variables (episode number, length of stay, number of days out of the hospital, and legal status at the time of admission), clinician-rated measures (Brief Psychiatric Rating Scale and Affective Disorder Rating Scale), and self-report measures (Brief Symptom Inventory, Internal State Scales, Short Michigan Alcohol Screening Test, Drug Abuse Screening Test, Barratt Impulsiveness Scale, Social Functioning Questionnaire and Multidimensional Scale of Perceived Social Support).Results:Men were more likely than women to be in the comorbid group [bipolar disorder and comorbid substance abuse (BPDSA)]. Whites were more likely than other groups to be diagnosed with BPDSA. Those with bipolar disorder alone (BPD) had more previous episodes, longer hospital stays, and less days out of the hospital between admissions. Among the rating scales, physicians and nurses were more likely to rate the BPD group with more severe symptoms. In contrast, the participants in the BPDSA group rated their own symptoms as more severe, in comparison with the BPD group.Conclusions:These results indicated that the BPD group were sicker overall than were those with comorbid substance abuse. This suggests that some of the symptoms seen in the BPDSA group may be attributable to substance use and therefore may have abated quickly once those individuals were unable to use substances.