Substance abuse by patients with bipolar disorder does not appear to slow their recovery, but it may indicate that patients have a more rapid cycling form of the disease, according to a study funded by the National Institute of Mental Health, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism.
A team of scientists studied 3750 patients with bipolar 1 or 2 disorder enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD), a multicenter prospective observational trial conducted from 1999 to 2005 (Ostacher MJ et al. Am J Psychiatry. 2010;167:289-297). The researchers hypothesized that patients with a current or past comorbid substance use disorder would experience a longer period between a major depressive episode and recovery than would those without such comorbidity. Although they did not find an association with past or current substance abuse with a longer time to recovery, they did find that patients with past or current substance abuse were more likely to experience rapid cycling from depression to manic, hypomanic, or mixed states.