Managing the Dual Diagnosis Dilemma of Bipolar Disorder and Substance Abuse in Clinical Settings

J Dual Diagn. 2024 Apr-Jun;20(2):178-187. doi: 10.1080/15504263.2024.2328600. Epub 2024 Mar 19.

Abstract

Objective: Drug addiction is a chronic mental disorder that significantly impacts all aspects of an individual's life, and substance use disorder in patients with bipolar disorder. The objective of this study is to assess the frequency of substance abuse among patients with bipolar spectrum disorder.

Method: This cross-sectional study evaluated the frequency of bipolar spectrum disorder in patients taking methadone through various screening measures, including Mini Mental State Examination (MMSE), DSM IV criteria, Mood Disorders Questionnaire (MDQ), Goodwin and Ghaemi's criteria, and Akiskal classification for bipolar disorders.

Results: Out of the total 197 participants in the study, 77 were identified as individuals engaging in poly-substance abuse. The investigation assessed the frequency of bipolar spectrum disorder based on various diagnostic criteria: 24% according to DSM-IV criteria, 29.9% using MDQ, 29.9% based on Ghaemi and Goodwin's criteria, and the highest rate at 48.2% when applying Akiskal's classification.

Conclusions: This study highlights the high frequency of bipolar disorder among individuals with substance use disorder, especially those with concomitant depression. Therefore, it is crucial to pay special attention to individuals with substance use disorder with co-existing bipolar disorder.

Keywords: Bipolar disorder; adult; depression; methadone; substance abuse.

MeSH terms

  • Bipolar Disorder* / complications
  • Bipolar Disorder* / diagnosis
  • Bipolar Disorder* / epidemiology
  • Cross-Sectional Studies
  • Diagnosis, Dual (Psychiatry)
  • Humans
  • Substance-Related Disorders* / complications
  • Substance-Related Disorders* / diagnosis
  • Substance-Related Disorders* / epidemiology
  • Surveys and Questionnaires