Skip to main content

15-08-2011 | Mental health | Article

Social drug use increased among bipolar spectrum depressed patients


Free abstract

MedWire News: Depressed patients who meet criteria for bipolar spectrum (BS) disorder use social drugs, such as coffee and tobacco, more frequently and in greater quantities than depressed patients who do not meet such criteria, say researchers.

"Across all ages and cultures, mankind has always used substances in order to induce pleasurable sensations or desirable psychophysiological states," explain Icro Maremmani (University of Pisa, Italy) and team. "These substances, notably caffeine, tobacco, alcohol, and chocolate, given their widely accepted recreational use, can be labeled 'social drugs.'"

They add that although previous studied have identified a link between bipolarity and substance abuse, little is known about social drug use among depressed BS patients.

To investigate, the team studied 562 patients, aged 18-75 years, who participated in the "Come to Me" study - a 7-month, multicentre, observational study of patients with a diagnosis of DSM-IV major depressive disorder.

All of the participants completed comprehensive questionnaires, from which their use of tobacco, coffee, and chocolate was ascertained.

The Hypomania Check-list 32 (HCL32) was used to assess the participants for BS. This is a check-list of 32 possible symptoms of hypomania that are rated "yes" (present or typical of me) or "no" (not present or not typical) - the cut-off for discrimination between unipolar and bipolar patients is fixed at a score of 14 out of 32.

In total, 256 patients met HCL criteria for BS, the researchers note in the Journal of Affective Disorders.

They found that 43.4% of BS patients were current users of tobacco and 78.9% "usually" drank coffee, compared with a respective 29.7% and 67.0% of those with non-bipolar depression.

Furthermore, among patients who smoked and/or drank coffee, BS patients smoked a mean of 10.5 cigarettes per day and drank a mean of 13.3 units of coffee a week compared with a respective 7.5 cigarettes and 10.3 units of coffee among non-bipolar depressive patients.

The differences in tobacco and coffee consumption between the groups were significant. However, there was no significant difference between the groups regarding the consumption of chocolate.

Maremmani and team conclude: "By using HCL32 criteria, we propose that the link between bipolar spectrum and substance use can be broadened to include social drugs like tobacco and coffee."

MedWire ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Mark Cowen

Related topics