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Cited by 35Bipolar Disorder and TreatmentSubstance Abuse Treatment and OutcomesSmoking Behavior and Cessation

Further Evidence for Smoking and Substance Use Disorders in Youth With Bipolar Disorder and Comorbid Conduct Disorder

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Wilens, Timothy E., Biederman, Joseph, Martelon, MaryKate, Zulauf, Courtney, Anderson, Jesse P., Carrellas, Nicholas W., Yule, Amy, Wozniak, Janet +2 more·2016·The Journal of Clinical Psychiatry
DOI 10.4088/jcp.14m09440PMC PMC6410713
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Abstract

OBJECTIVE: Bipolar disorder (BPD) is a highly morbid disorder increasingly recognized in adolescents. The aim of this study was to examine the relative risk for substance use disorders (SUDs; alcohol or drug abuse or dependence) and cigarette smoking in adolescents with BPD. METHODS: We evaluated the relative risk for SUDs and cigarette smoking in a case-controlled, 5-year prospective follow-up of adolescents with (n = 105, mean ± SD baseline age = 13.6 ± 2.5 years) and without ("controls"; n = 98, baseline age = 13.7 ± 2.1 years) BPD. Seventy-three percent of subjects were retained at follow-up (BPD: n = 68; controls: n = 81; 73% reascertainment). Our main outcomes were assessed by blinded structured interviews for DSM-IV criteria. RESULTS: Maturing adolescents with BPD, compared to controls, were more likely to endorse higher rates of SUD (49% vs 26%; hazard ratio [HR] = 2.0; 95% confidence interval (CI), 1.1-3.6; P = .02) and cigarette smoking (49% vs 17%; HR = 2.9; 95% CI, 1.4-6.1; P = .004), as well as earlier onset of SUD (14.9 ± 2.6 [SD] years vs 16.5 ± 1.6 [SD] years; t = 2.6; P = .01). Subjects with conduct disorder (CD) were more likely to have SUD and nicotine dependence than subjects with BPD alone or controls (all P values < .05). When we added conduct disorder to the model with socioeconomic status and parental SUD, all associations lost significance (all P values > .05). Subjects with the persistence of a BPD diagnosis were also more likely to endorse cigarette smoking and SUD in comparison to those who lost a BPD diagnosis or controls at follow-up. CONCLUSIONS: The results provide further evidence that adolescents with BPD, particularly those with comorbid CD, are significantly more likely to endorse cigarette smoking and SUDs when compared to their non-mood disordered peers. These findings indicate that youth with BPD should be carefully monitored for comorbid CD and the development of cigarette smoking and SUDs.

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  • In a sample of adolescents with bipolar disorder followed into young adulthood, those with low-level bipolar symptoms (treated and nonpersistent group) were similar to non-mood disordered controls and were at lower risk for SUD compared to those with prominent bipolar symptoms.

    “Similarly, we previously showed that in a sample of adolescents with bipolar disorder followed into young adulthood, those with low-level bipolar symptoms (e.g., treated and nonpersistent group) were similar to non-mood disordered controls and were at lower risk for SUD compared to those with prominent bipolar symptoms (Wilens et al. 2016).”

    From The Impact of Pharmacotherapy of Childhood-Onset Psychiatric Disorders on the Development of Substance Use Disorders (2022) · cites this paper as Wilens et al. 2016

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Research works printed but not linked: 3

  1. [9]Regier DA, Farmer ME, Rae DS, Comorbidity of mental disorders with alcohol and other drug abuse. JAMA 1990; 264: 2511– 2518. 2232018
  2. [36]Mezzich AC, Tarter RE, Hsieh Y, Fuhrman A. Substance abuse severity in female adolescents. Association between age at menarche and chronological age. The American Journal on Addictions 1992; 1: 217– 221.
  3. [38]Winokur G, Coryell W, Akiskal HS, Alcoholism in manic-depressive (bipolar) illness: Familial illness, course of illness, and the primary-secondary distinction. American Journal of Psychiatry 1995; 152(3): 365– 372. 7864261

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Authors
Wilens, T. E., Biederman, J., Martelon, M., Zulauf, C., Anderson, J. P., Carrellas, N. W., Yule, A., Wozniak, J., Fried, R., & Faraone, S. V.
Affiliations
  • Harvard University (US)
  • Massachusetts General Hospital (US)
  • SUNY Upstate Medical University (US)
ORCID
Venue
The Journal of Clinical Psychiatry
Publisher
Physicians Postgraduate Press, Inc
Published
2016-08-30
Volume
77
Issue
10
Pages
1420-1427
ISSN
0160-6689 (ISSN-L)
DOI
10.4088/jcp.14m09440
PMC
PMC6410713
OpenAlex
W2512827572
Cited by
35
References
40
Citations by year
2024: 1 · 2023: 2 · 2022: 6 · 2021: 4 · 2020: 5 · 2019: 4 · 2018: 6 · 2017: 7
FWCI
5.04
Type
journal article
Language
en
Open access
Locations
  • The Journal of Clinical Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute on Drug Abuse (K24DA016264, R01DA012945, K12DA000357)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
Keywords
bipolar disorder, conduct disorder, substance use disorders, adolescent smoking, nicotine dependence, comorbidities, adolescents, parental substance use
MeSH terms
Adolescent, Alcoholism, Attention Deficit Disorder with Hyperactivity, Bipolar Disorder, Cross-Sectional Studies, Female, Humans, Longitudinal Studies, Male, Massachusetts, Reference Values, Risk, Sex Factors, Smoking, Comorbidity, Case-Control Studies, Conduct Disorder, Substance-Related Disorders, Young Adult

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