Substance use and course of bipolar disorder in an inpatient sample.

INTRODUCTION: Patients with bipolar disorder (BD) have a comorbid substance use with high frequency. Our study aims to establish a relationship between substance use and BD, in terms of greater diagnostic difficulty, a worse prognosis and changes in pharmacological prescription.

METHODS: The sample consisted of 394 subjects over twenty years were hospitalized with a diagnosis of BD in acute psychiatry unit of a general hospital (10.6% of total of 3,704 patients). The medical records were analyzed for demographic, clinical and family group relating to data subjects.

RESULTS: Complete data were obtained from 319 patients. Of these 165 (51.7%) had a history of drug consumption (abuse/dependence). This was more frequent in men (79.7% vs. 34.2%), in patients under 65 years (58.4% vs. 16.7%) and BD type I compared to type II (55% vs. 35%). Consumers substance patients had an age of onset of the disease earlier and more diagnostic difficulties. Regarding treatment, receiving discharge more mood stabilizers and antipsychotics than nonusers, and higher doses of most of them.

CONCLUSIONS: The cases of dual pathology were detected in more than half of the sample, being the most serious and poorer prognosis patients, besides presenting a debut earlier disease. BD / substance use association was more common in men and in patients under 65 years.