Unexpected Effect of Substance Use Disorders on Recovery From Bipolar Depression

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The likelihood of full recovery or time to full recovery was not predicted by past substance use disorders.
The likelihood of full recovery or time to full recovery was not predicted by past substance use disorders.

Patients with co-occurring bipolar disorder and substance use disorders were more likely to respond to treatment with a full recovery from a depressive episode than patients without a co-occurring substance use disorder, according to a study published in the Australian and New Zealand Journal of Psychiatry.

Researchers of the current study conducted a post hoc analysis of 270 bipolar disorder patients with or without a co-occurring substance use disorder who were enrolled in a randomized psychosocial intervention trial (the Systematic Treatment Enhancement Program for Bipolar Disorder). Cox proportional hazard models and logistic regression were used to assess the effect of past or current substance use disorders on patient response. Patients entered the trial during or soon after the onset of a depressive bipolar episode.

Contrary to the investigators' hypotheses, it was found that current co-occurring substance use disorders could significantly predict the likelihood of recovery from an episode of bipolar depression (OR=2.25, P =.025), as well as the time to recovery (OR=1.71, P =.006), and did not significantly impact patient response to collaborative care vs intensive psychotherapy. Full recovery from bipolar depression was seen in 74.5% of patients with current co-occurring substance use disorders and in 56.5% of patients without current co-occurring substance use disorders. The likelihood of full recovery or time to full recovery was not predicted by past substance use disorders.

Study investigators conclude that this study enhances “options for the ordering of treatment of comorbid [bipolar disorder] and [substance use disorders], suggesting that psychosocial treatment can intervene effectively with bipolar depression prior to treating the [substance use disorder].”

This study was supported by the Dauten Family Center for Bipolar Treatment Innovation. Please refer to reference for a complete list of authors' disclosures.

Reference

Gold AK, Peters AT, Otto MW, et al. The impact of substance use disorders on recovery from bipolar depression: results from the Systematic Treatment Enhancement Program for Bipolar Disorder psychosocial treatment trial [published online July 26, 2018]. Aust N Z J Psychiatry. doi:10.1177/0004867418788172

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