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European Psychiatry
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le samedi 1 octobre 2011
Doi : 10.1016/j.eurpsy.2011.07.004
Received : 28 April 2011 ;  accepted : 10 July 2011
Screening for bipolar disorder among outpatients with substance use disorders
 

A. Nallet a, B. Weber a, S. Favre a, M. Gex-Fabry c, R. Voide a, F. Ferrero c, D. Zullino b, Y. Khazaal b, J.M. Aubry a, ⁎
a Geneva University Hospital, Department of Mental Health and Psychiatry, Service of General Psychiatry, Bipolar Program, 6–8, rue du 31-Décembre, 1207 Geneva, Switzerland 
b Geneva University Hospital, Department of Mental Health and Psychiatry, Service of Addictology, 2, rue Verte, 1205 Geneva, Switzerland 
c Geneva University Hospital, Department of Mental Health and Psychiatry, Service of General Psychiatry, 2, chemin du Petit-Bel-Air, 1225 Chêne-Bourg, Switzerland 

Corresponding author. Tel.: +41 22 305 45 38; fax: +41 22 305 45 99.
Abstract
Background

Comorbidity of bipolar disorder and alcohol or substance abuse/dependence is frequent and has marked negative consequences on the course of the illness and treatment compliance. The objective of this study was to compare the validity of two short instruments aimed at screening bipolar disorders among patients treated for substance use disorders.

Methods

The Mood Disorder Questionnaire (MDQ) and the Hypomania Checklist-32 (HCL-32) were tested with reference to the mood section of the Structured Clinical Interview for DSM-IV axis I disorders (SCID) in 152 patients, recruited in two outpatient clinics providing specialized treatment for alcohol and opiate dependence.

Results

According to the SCID, 33 patients (21.7%) had a diagnosis within the bipolar spectrum (two bipolar I, 21 bipolar II and 10 bipolar not otherwise specified). The HCL-32 was more sensitive (90.9% vs. 66.7%) and the MDQ more specific (38.7% vs. 77.3%) for the whole sample. The MDQ displayed higher sensitivity and specificity in patients treated for alcohol than for opiate dependence, whereas the HCL-32 was highly sensitive but poorly specific in both samples. Both instruments had a positive predictive value under 50%.

Conclusions

Caution is needed when using the MDQ and HCL-32 in patients treated for substance use disorders.


Keywords : MDQ, HCL-32, Comorbidity, Bipolar type I and II, Alcohol dependence, Opiate dependence


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Introduction
Methods  (+)
Results  (+)
Discussion
Conclusion
Disclosure of interest


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