Bipolar disorder and substance use disorders in a Tunisian sample

Abstract

Aims

Describe the sociodemographic and clinical profile of patients suffering from bipolar disorder and substance use disorders comorbidity and assess the consequences of this comorbidity on prognosis and evolution of bipolar disorder,

Methods

A case-control study, 100 euthymic patients treated for bipolar disorder, recruited in the department of psychiatry C of Razi hospital. Two groups of 50 patients were individualized by the presence or not of substance use disorders comorbidity. The two groups were compared for sociodemographic, clinical, therapeutic and historical characteristics.

Results

Compared to bipolar patients without addictive comorbidity, those with this comorbidity had the following characteristics: we found more male, less family cohesion, more domestic violence, more criminal records, more time spent abroad, more personality disorders especially antisocial and borderline, fewer triggers of bipolar illness, more mood episodes, more psychotic features, higher impulsivity BIS-10 score, an increased need to put in a neuroleptic long term treatment, poor adherence to treatment, lower response to treatment, lower score of global assessment of functioning (GAF), more rapid cycles, shorter period of remission, longer duration of the last mood episode, poor socio-professional integration and poor quality of intervals between mood episodes.

Conclusions

It seems important to insist on the identification and the treatment of bipolar disorder or substance use disorders when one of them is diagnosed. This needs to set up urgently facilities and care structures for patients with substance use disorders and to create more addiction consultations.

Disclosure of interest

The authors have not supplied their declaration of competing interest.