Hostname: page-component-7c8c6479df-ws8qp Total loading time: 0 Render date: 2024-03-27T22:09:19.166Z Has data issue: false hasContentIssue false

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

Published online by Cambridge University Press:  10 December 2007

P. A. Ringen*
Affiliation:
Institute of Psychiatry, Medical Faculty, University of Oslo, Oslo, Norway
T. V. Lagerberg
Affiliation:
Institute of Psychiatry, Medical Faculty, University of Oslo, Oslo, Norway
A. B. Birkenæs
Affiliation:
Division of Psychiatry, Ullevål University Hospital, Oslo, Norway
J. Engn
Affiliation:
Division of Psychiatry, Ullevål University Hospital, Oslo, Norway
A. Færden
Affiliation:
Division of Psychiatry, Ullevål University Hospital, Oslo, Norway
H. Jónsdottir
Affiliation:
Division of Psychiatry, Ullevål University Hospital, Oslo, Norway
R. Nesvåg
Affiliation:
Department of Psychiatry, Diakonhjemmet Hospital, Oslo, Norway
S. Friis
Affiliation:
Division of Psychiatry, Ullevål University Hospital, Oslo, Norway
S. Opjordsmoen
Affiliation:
Division of Psychiatry, Ullevål University Hospital, Oslo, Norway
F. Larsen
Affiliation:
Division of Psychiatry, Ullevål University Hospital, Oslo, Norway
I. Melle
Affiliation:
Institute of Psychiatry, Medical Faculty, University of Oslo, Oslo, Norway
O. A. Andreassen
Affiliation:
Division of Psychiatry, Ullevål University Hospital, Oslo, Norway
*
*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)

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.

Type
Original Articles
Copyright
Copyright © 2007 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn.American Psychological Association: Washington, DC.Google Scholar
Cadet, JL, Krasnova, IN, Jayanthi, S, Lyles, J (2007). Neurotoxicity of substituted amphetamines: molecular and cellular mechanisms. Neurotoxicity Research 11, 183202.Google Scholar
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.CrossRefGoogle Scholar
Cassidy, F, Ahearn, EP, Carroll, BJ (2001). Substance abuse in bipolar disorder. Bipolar Disorders 3, 181188.Google Scholar
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.Google Scholar
Craddock, N, O'Donovan, MC, Owen, MJ (2006). Genes for schizophrenia and bipolar disorder? Implications for psychiatric nosology. Schizophrenia Bulletin 32, 916.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle Scholar
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.Google Scholar
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.Google Scholar
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.CrossRefGoogle ScholarPubMed
Green, AI, Drake, RE, Brunette, MF, Noordsy, DL (2007). Schizophrenia and co-occurring substance use disorder. American Journal of Psychiatry 164, 402408.CrossRefGoogle ScholarPubMed
Green, B, Young, R, Kavanagh, D (2005). Cannabis use and misuse prevalence among people with psychosis. British Journal of Psychiatry 187, 306313.Google Scholar
Hashibe, M, Straif, K, Tashkin, DP, Morgenstern, H, Greenland, S, Zhang, ZF (2005). Epidemiologic review of marijuana use and cancer risk. Alcohol 35, 265275.CrossRefGoogle ScholarPubMed
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.Google Scholar
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.Google Scholar
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.CrossRefGoogle ScholarPubMed
Kavanagh, DJ, McGrath, J, Saunders, JB, Dore, G, Clark, D (2002). Substance misuse in patients with schizophrenia: epidemiology and management. Drugs 62, 743755.CrossRefGoogle Scholar
Khantzian, EJ (1985). The self medication hypothesis of addictive disorders: focus on heroin and cocaine dependence. American Journal of Psychiatry 142, 12591264.Google Scholar
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle Scholar
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.CrossRefGoogle Scholar
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.Google Scholar
Mueser, KT, Noordsy, DL, Drake, RE, Fox, L (2003). Integrated Treatment for Dual Disorders: A Guide to Effective Practice. The Guilford Press: New York.Google Scholar
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.CrossRefGoogle ScholarPubMed
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.Google Scholar
Norwegian Institute for Alcohol and Drug Research (2006). Rusmidler i Norge 2006. SIRIUS: Oslo (http://www.sirus.no). Accessed 1 December 2006.Google Scholar
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.Google Scholar
Picchioni, MM, Murray, RM (2000). Overvalued ideas about alcoholism and schizophrenia. Addiction 95, 18601863.Google Scholar
Potvin, S, Sephery, AA, Stip, E (2005). A meta-analysis of negative symptoms in dual diagnosis schizophrenia. Psychological Medicine 36, 431440.Google Scholar
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle Scholar
Strakowski, SM, DelBello, MP, Fleck, DE, Arndt, S (2000). The impact of substance abuse on the course of bipolar disorder. Biological Psychiatry 48, 477485.Google Scholar
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.CrossRefGoogle ScholarPubMed
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.Google Scholar
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.Google Scholar
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.CrossRefGoogle ScholarPubMed
Verdoux, H, Mury, M, Besancon, G, Bourgeois, M (1996). Comparative study of substance dependence comorbidity in bipolar, schizophrenic and schizoaffective disorders. Encephale 22, 95101.Google ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.Google Scholar