SUBSTANCE-ABUSE AND BIPOLAR AFFECTIVE-DISORDER

This interview study was conducted to explore the onset, course, and f eatures of bipolar affective disorder complicated by substance abuse. Forty-four patients with a diagnosis of bipolar affective disorder wer e interviewed using the Structured Clinical Interview for DSM-III-R, H amilton Rating Scale for Depression, Young Mania Rating Scale, and a q uestionnaire concerning psychiatric history. Current substance users a veraged twice as many hospitalizations for mood problems. The age of o nset of mood problems for substance users was significantly earlier th an that of the nonusers (p less than or equal to .05). Substance users were four times as likely to have other comorbid axis I disorders (p less than or equal to .05) and twice as likely to have dysphoric mania at time of interview. This preliminary study suggests that individual s with bipolar affective disorder complicated by substance abuse may h ave more hospitalizations, a higher incidence of dysphoric mania, earl ier onset of mood problems, and more comorbid axis I disorders.