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Differences in prevalence and patterns of substance use in schizophrenia and bipolar disorder

  • P. A. Ringen (a1), T. V. Lagerberg (a1), A. B. Birkenæs (a2), J. Engn (a2), A. Færden (a2), H. Jónsdottir (a2), R. Nesvåg (a3), S. Friis (a2), S. Opjordsmoen (a2), F. Larsen (a2), I. Melle (a1) and O. A. Andreassen (a2)...

Abstract

Background

Schizophrenia and bipolar disorder have partly overlapping clinical profiles, which include an over-representation of substance-use behaviour. There are few previous studies directly comparing substance-use patterns in the two disorders. The objective of the present study was to compare the prevalence of substance use in schizophrenia and bipolar disorder, and investigate possible differences in pattern and frequency of use.

Method

A total of 336 patients with schizophrenia or bipolar spectrum disorder from a catchment area-based hospital service were included in a cross-sectional study. In addition to thorough clinical assessments, patients were interviewed about drug-use history, habits and patterns of use. The prevalence and drug-use patterns were compared between groups.

Results

Patients with bipolar disorder had higher rates of alcohol consumption, while schizophrenia patients more often used centrally stimulating substances, had more frequent use of non-alcoholic drugs and more often used more than one non-alcoholic drug. Single use of cannabis was more frequent in bipolar disorder.

Conclusion

The present study showed diagnosis-specific patterns of substance use in severe mental disorder. This suggests a need for more disease-specific treatment strategies, and indicates that substance use may be an important factor in studies of overlapping disease mechanisms.

Copyright

Corresponding author

*Address for correspondence: Dr P. A. Ringen, Department of Education and Research, Division of Psychiatry, Building 49, Ullevål University Hospital, N-0407Oslo, Norway. (Email: p.a.ringen@medisin.uio.no)

References

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APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn.American Psychological Association: Washington, DC.
Cadet, JL, Krasnova, IN, Jayanthi, S, Lyles, J (2007). Neurotoxicity of substituted amphetamines: molecular and cellular mechanisms. Neurotoxicity Research 11, 183202.
Caspi, A, Moffit, TE, Cannon, M, McClay, J, Murray, R, Harrington, H, Taylor, A, Arseneault, L, Williams, B, Braithwaite, A, Poulton, R, Craig, IW (2005). Moderation of the effect of adolescent-onset cannabis use on adult psychosis by a functional polymorphism in the catechol-o-methyltransferase gene: longitudinal evidence of a gene×environment interaction. Biological Psychiatry 57, 11171127.
Cassidy, F, Ahearn, EP, Carroll, BJ (2001). Substance abuse in bipolar disorder. Bipolar Disorders 3, 181188.
Chengappa, KNR, Levine, J, Gershon, S, Kupfer, DJ (2000). Lifetime prevalence of substance or alcohol abuse and dependence among subjects with bipolar I and II disorders in a voluntary registry. Bipolar Disorder 2, 191195.
Craddock, N, O'Donovan, MC, Owen, MJ (2006). Genes for schizophrenia and bipolar disorder? Implications for psychiatric nosology. Schizophrenia Bulletin 32, 916.
Crow, TJ (1998). From Kraepelin to Kretschmer leavened by Schneider. The transition from categories of psychosis to dimensions of variation intrinsic to Homo sapiens. Archives of General Psychiatry 55, 502504.
Daban, C, Martinez-Aran, A, Torrent, C, Tabarés-Seisdedos, R, Balanzá-Martínez, V, Salazar-Fraile, J, Selva-Vera, G, Vieta, E (2006). Specificity of cognitive deficits in bipolar disorder versus schizophrenia. A systematic review. Psychotherapy and Psychosomatics 75, 7284.
de Leon, J, Diaz, FJ, Rogers, T, Browne, D, Dinsmore, L (2002). Initiation of daily smoking and nicotine dependence in schizophrenia and mood disorders. Schizophrenia Research 56, 4754.
Drake, RE, Osher, FC, Wallach, MA (1989). Alcohol use and abuse in schizophrenia: a prospective community study. Journal of Nervous and Mental Disorder 177, 408414.
D'Souza, DC, Gil, RB, Madonick, S, Perry, EB, Forselius-Bielen, K, Braley, G, Donahue, L, Tellioglu, T, Zimolo, Z, Gueorguieva, R, Krystal, JH (2006). Enhanced sensitivity to the euphoric effects of alcohol in schizophrenia. Neuropsychopharmacology 31, 27672775.
Etter, M, Etter, J-F (2004). Alcohol consumption and the CAGE test in outpatients with schizophrenia or schizoaffective disorder and in the general population. Schizophrenia Bulletin 30, 947956.
European Monitoring Centre for Drugs and Drug Addiction (2006). Annual Report 2006: The state of the drugs problem in Europe. EMCDDA: Lisbon, Portugal (http://ar2006.emcdda.europa.eu/en/home-en.html). Accessed 12 December 2006.
Farrell, M, Howes, S, Taylor, C, Lewis, G, Jenkins, R, Bebbington, P, Jarvis, M, Brugha, T, Gill, B, Meltzer, H (1998). Substance misuse and psychiatric comorbidity: an overview of the OPCS National Psychiatric Morbidity Survey. Addictive Behaviors 23, 909918.
Green, AI, Drake, RE, Brunette, MF, Noordsy, DL (2007). Schizophrenia and co-occurring substance use disorder. American Journal of Psychiatry 164, 402408.
Green, B, Young, R, Kavanagh, D (2005). Cannabis use and misuse prevalence among people with psychosis. British Journal of Psychiatry 187, 306313.
Hashibe, M, Straif, K, Tashkin, DP, Morgenstern, H, Greenland, S, Zhang, ZF (2005). Epidemiologic review of marijuana use and cancer risk. Alcohol 35, 265275.
Henquet, C, Krabbendam, L, de Graaf, R, ten Have, M, van Os, J (2006). Cannabis use and expression of mania in the general population. Journal of Affective Disorders 95, 103110.
Henquet, C, Krabbendam, L, Spauwen, J, Kaplan, C, Lieb, R, Wittchen, H-U, van Os, J (2005). Prospective cohort study of cannabis use, predisposition for psychosis, and psychotic symptoms in young people. British Medical Journal 330, 1116.
Joyal, CC, Hallé, P, Lapierre, D, Hodgins, S (2003). Substance abuse and/or dependence and better neuropsychological performance in patients with schizophrenia. Schizophrenia Research 63, 297299.
Kavanagh, DJ, McGrath, J, Saunders, JB, Dore, G, Clark, D (2002). Substance misuse in patients with schizophrenia: epidemiology and management. Drugs 62, 743755.
Khantzian, EJ (1985). The self medication hypothesis of addictive disorders: focus on heroin and cocaine dependence. American Journal of Psychiatry 142, 12591264.
Kilbourne, AM, Cornelius, JR, Han, X, Pincus, HA, Shad, M, Salloum, I, Conigliaro, J, Haas, GL (2004). Burden of general medical conditions among individuals with bipolar disorder. Bipolar Disorders 6, 368373.
Miles, H, Johnson, S, Amponsah-Afuwape, S, Finch, E, Leese, M, Thornicroft, G (2003). Characteristics of subgroups of individuals with psychotic illness and a comorbid substance use disorder. Psychiatric Services 54, 554561.
Moore, TH, Zammit, S, Lingford-Hughes, A, Barnes, TR, Jones, PB, Burke, M, Lewis, G (2007). Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review. Lancet 28, 319328.
Mueser, KT, Essock, SM, Drake, RE, Wolfe, RS, Frisman, L (2001). Rural and urban differences in patients with a dual diagnosis. Schizophrenia Research 48, 93107.
Mueser, KT, Noordsy, DL, Drake, RE, Fox, L (2003). Integrated Treatment for Dual Disorders: A Guide to Effective Practice. The Guilford Press: New York.
Mueser, KT, Yarnold, PR, Bellack, AS (1992). Diagnostic and demographic correlates of substance abuse in schizophrenia and major affective disorder. Acta Psychiatrica Scandinavica 85, 4855.
Murray, RM, Sham, P, Van Os, J, Zanelli, J, Cannon, M, McDonald, C (2004). A developmental model for similarities and dissimilarities between schizophrenia and bipolar disorder. Schizophrenia Research 71, 405416.
Norwegian Institute for Alcohol and Drug Research (2006). Rusmidler i Norge 2006. SIRIUS: Oslo (http://www.sirus.no). Accessed 1 December 2006.
Office of Applied Studies, Substance Abuse and Mental Health Services Administration (2006). Drugs (heroin, PCP, LSD, cocaine, club drugs, alcohol, tobacco, marijuana, etc.) on SAMHSA's Office of Applied Studies website. US Department of Health and Mental Services: Rockville, MD (http://www.oas.samhsa.gov/drugs.cfm). Accessed 12 December 2006.
Picchioni, MM, Murray, RM (2000). Overvalued ideas about alcoholism and schizophrenia. Addiction 95, 18601863.
Potvin, S, Sephery, AA, Stip, E (2005). A meta-analysis of negative symptoms in dual diagnosis schizophrenia. Psychological Medicine 36, 431440.
Regier, DA, Farmer, ME, Rae, DS, Locke, BZ, Keith, SJ, Judd, LL, Goodwin, FK (1990). Comorbidity of mental disorders and other substance abuse. Results from the epidemiologic catchment area (ECA) study. Journal of the American Medical Association 264, 25112518.
Rehm, J, Room, R, van den Brink, W, Kraus, L (2005). Problematic drug use disorders in EU countries and Norway: an overview of the epidemiology. European Neuropsychopharmacology 15, 389397.
Sherwood Brown, E, Suppes, T, Adinoff, B, Rajan Thomas, N (2001). Substance abuse and bipolar disorder: comorbidity or misdiagnosis? Journal of Affective Disorders 65, 105115.
Strakowski, SM, DelBello, MP, Fleck, DE, Adler, CM, Anthenelli, R, Keck, PE, Arnold, LM, Amicone, J (2007). Effects of co-occuring cannabis use disorders on the course of bipolar disorder after a first hospitalization of mania. Archives of General Psychiatry 64, 5764.
Strakowski, SM, DelBello, MP, Fleck, DE, Arndt, S (2000). The impact of substance abuse on the course of bipolar disorder. Biological Psychiatry 48, 477485.
Swartz, MS, Wagner, HR, Swanson, JW, Scott Stroup, T, McEvoy, JP, Canive, JM, Miller, DD, Reimherr, F, McGee, M, Khan, A, Van Dorn, R, Rosenheck, RA, Liebermann, JA (2006). Substance use in persons with schizophrenia. Baseline prevalence and correlates from the NIMH CATIE study. Journal of Nervous and Mental Disorders 194, 164172.
Talamo, A, Centorino, F, Tondo, L, Dimitri, A, Hennen, J, Baldessarini, RJ (2006). Comorbid substance abuse in schizophrenia: relation to positive and negative symptoms. Schizophrenia Research 86, 251255.
Van Os, J, Bak, M, Hanssen, M, Bijl, RV, de Graaf, R, Verdoux, H (2002). Cannabis use and psychosis: a longitudinal population-based study. American Journal of Epidemiology 156, 319327.
Ventura, J, Liberman, RP, Green, MF, Shaner, A, Mintz, J (1998). Training and quality assurance with the Structured Clinical Interview for DSM-IV I/P (SCID). Psychiatry Research 79, 163173.
Verdoux, H, Mury, M, Besancon, G, Bourgeois, M (1996). Comparative study of substance dependence comorbidity in bipolar, schizophrenic and schizoaffective disorders. Encephale 22, 95101.
Weiss, RD, Kolodziej, M, Griffin, ML, Najavits, LM, Jacobson, LM, Greenfield, SF (2004). Substance use and perceived symptom improvement among patients with bipolar disorder and substance dependence. Journal of Affective Disorders 79, 279283.
Winokur, G, Turvey, C, Akiskal, H, Coryell, W, Solomon, S, Leon, A, Mueller, T, Endicott, J, Maser, J, Keller, M (1998). Alcoholism and substance abuse in three groups – bipolar I, unipolars and their acquaintances. Journal of Affective Disorders 50, 8189.
Ziedonis, D, Williams, JM, Smelson, D (2003). Serious mental illness and tobacco addiction: a model program to address this common but neglected issue. American Journal of the Medical Sciences 326, 223230.

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Differences in prevalence and patterns of substance use in schizophrenia and bipolar disorder

  • P. A. Ringen (a1), T. V. Lagerberg (a1), A. B. Birkenæs (a2), J. Engn (a2), A. Færden (a2), H. Jónsdottir (a2), R. Nesvåg (a3), S. Friis (a2), S. Opjordsmoen (a2), F. Larsen (a2), I. Melle (a1) and O. A. Andreassen (a2)...

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