Risk and Protective Factors Associated With Substance Use Disorders in Adolescents With First-Episode Mania - 21/06/14
Abstract |
Objective |
Adolescents with bipolar disorder (BD) are more likely to develop substance use disorders (SUDs) than adolescents without psychiatric disorders; however, to our knowledge, specific risk factors underlying this relationship have not been prospectively examined. The purpose of this study was to identify predictors of developing SUDs after a first manic episode.
Method |
Participants aged 12 to 20 years and hospitalized with their first manic episode associated with bipolar I disorder (BP-I) were recruited as part of the University of Cincinnati First-Episode Mania Study and prospectively evaluated for patterns of substance use. Follow-up ranged between 17 and 283 weeks (mean = 113 weeks, SD = 71.9 weeks). Demographic and clinical variables were compared between adolescents with and without SUDs.
Results |
Of the 103 adolescents with BD, 49 (48%) either had a SUD at baseline or developed one during follow-up. Of the 71 participants who did not have a SUD at study entry, 17 (24%) developed one during follow-up (median = 40 weeks). Later onset of BD, manic (versus mixed) mood episode, and comorbid disruptive behavior disorders were associated with an increased risk of developing a SUD in univariate analyses. Adolescents treated with psychostimulant treatment before their first manic episode were significantly less likely to develop a SUD independent of attention-deficit/hyperactivity disorder (ADHD) diagnosis. Comorbid posttraumatic stress disorder (PTSD) and psychotic symptoms were the strongest predictors of SUD development.
Conclusion |
Our results confirm high rates of SUD in adolescents with BD. In addition, our findings identify potential risk factors associated with SUDs in adolescents with BD. These data are preliminary in nature and should be explored further in future studies.
Le texte complet de cet article est disponible en PDF.Key Words : bipolar disorder, substance use disorders, mania, first episode
Plan
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| This article can be used to obtain continuing medical education (CME) at www.jaacap.org. |
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| An interview with the author is available by podcast at www.jaacap.org or by scanning the QR code to the right. |
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| This article was reviewed under and accepted by deputy editor Ellen Leibenluft, MD |
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| Funding for this study came from National Institute of Mental Health (NIMH) grants #63373 (M.P.D.) and #58170 (S.M.S.) and the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health (NIH) grant 8 UL1 TR000077-05. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIMH or NIH. |
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| Dr. Welge served as the statistical expert for this research. |
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| Disclosure: Dr. Heffner has served as a consultant for Pfizer. Dr. Adler has received research support from AstraZeneca, Amylin, Elan, Eli Lilly and Co., GlaxoSmithKline, Lundbeck, Martek, Merck, Novartis, Otsuka, Pfizer, Purdue, Shire, Sunovion, and Takeda. He has been on the lecture bureau for Merck and Sunovion, for which he has received honoraria. Dr. Anthenelli has received research support from Pfizer, GlaxoSmithKline, the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute on Drug Abuse (NIDA), and the Department of Veterans Affairs. He also provides consultancy and/or advisory board services to Pfizer. Dr. Fleck has received research support from NIH and honoraria from Elsevier and the US Army Medical Research and Materiel Command (USAMRMC). Dr. Strakowski serves as Chair of Data and Safety Monitoring Boards (DSMBs) for Sunovion Pharmaceutical and Novartis and as a consultant to Procter and Gamble. Dr. DelBello has received grant or research support from NIMH, NIAAA, NIDA, the National Institute of Diabetes and Digestive and Kidney Diseases, the Depressive and Bipolar Alternative Treatment Foundation, the University of Cincinnati Neuroscience Institute, AstraZeneca, Amylin, Eli Lilly and Co., Pfizer, Otsuka, GlaxoSmithKline, Merck, Martek, Novartis, Lundbeck, Purdue, Sunovion, and Shire. She has served as a consultant to Bracket, Guilford, Merck, Pfizer, Dey Pharma, Lundbeck, Springer, Sunovion, Supernus, and Otsuka. She has served on the speakers' bureau for Otsuka, Merck, and Bristol-Myers Squibb. She has received royalties from Guilford Press and has presented expert testimony for University of Cincinnati Health. Dr. Welge, Mr. Stephens, and Mr. Blom report no biomedical financial interests or potential conflicts of interest. |
Vol 53 - N° 7
P. 771-779 - juillet 2014 Retour au numéro
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