SUD significantly worsens social functioning in bipolar patients
MedWire News: The presence of substance use disorder (SUD) is associated with a significant reduction in social functioning among patients with bipolar disorder, say French researchers.
Caroline Dubertret (Louis Mourier Hospital, Colombes, France) and team explain that, overall, bipolar disorder is considered to have a better prognosis than schizophrenia.
"Many people with bipolar illness respond well to treatment and pursue functional lives, albeit with interruptions due to relapses," the researchers explain.
But they add that comorbid conditions, particularly SUD, may have a significant negative effect on psychosocial functioning in such patients.
The team studied 40 stable patients with schizophrenia and 40 stable patients with bipolar disorder who were matched for age, gender, and presence of SUD (DSM-IV criteria).
The participants' social adjustment over the previous 2 months was assessed using the Social Adjustment Scale (SAS), which consists of 51 items covering social functioning in areas such as work, education, leisure, and family life, with higher scores reflecting poorer adjustment.
After accounting for demographic and clinical characteristics, the researchers found that bipolar patients with SUD had a significantly poorer average global adaption score on the SAS than bipolar patients without SUD, at 4.5 versus 3.2.
Indeed, this average global adaption score for bipolar patients with SUD was not significantly different from those of schizophrenia patients with and without SUD, at 5.0 and 4.2, respectively.
The researchers also found that bipolar patients with SUD had attempted suicide and engaged in criminal activity more frequently, and had longer periods of hospitalization and shorter periods of remission than bipolar patients without SUD.
Dubertret and team conclude in the journal Psychiatry Research: "We found that patients with bipolar disorder with SUD comorbidity have a worse course and more frequent harmful consequences of their disorder than bipolar patients without such lifetime comorbidity, with an associated worse social adjustment that was not significantly different to that observed in patients with schizophrenia but without SUD."
They add: "The present findings underline the importance of considering and systematically researching the co-occurrence of SUD among patients with bipolar disorder."
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2011
By Mark Cowen