SUDs common in youth at high risk for bipolar disorder

By Mark Cowen, Senior medwireNews Reporter

Around a quarter of young people at high risk for mood disorders have a substance use disorder (SUD), results from a Canadian study suggest.

In a study of 211 high-risk individuals aged 12 years or older with a parental history of bipolar disorder, Anne Duffy (University of Calgary, Alberta) and team found that 24% met criteria for a lifetime SUD.

Furthermore, over a mean follow-up period of 5.2 years, the risk for developing a major mood disorder in those with a prior SUD was almost three times greater than in those without (hazard ratio [HR]=2.99), and the risk for bipolar disorder (BD) specifically was even higher (HR=3.40).

The presence of an SUD was also associated with an increased risk for psychosis (HR=3.23).

Considering the previously reported negative impact of SUDs in people with BD, "the early identification and prevention of SUD in this identifiable population of high-risk young people should be a major public health priority," comment the researchers in the Journal of Affective Disorders.

The mean age at SUD onset among the participants who met DSM-IV criteria for such a disorder was 17.1 years, with the peak hazard age range between 14 and 20 years.

The most common substance abused was cannabis, at 16.6% of the total sample, followed by alcohol, at 13.7%. Of the participants with an SUD, 32% had two or more lifetime SUD diagnoses.

Male gender and a parental history of SUDs were significant predictors for SUDs in the participants, at HRs of 3.29 and 3.00, respectively.

"The major findings of this study support that SUD is a major clinical problem occurring early in the evolving course of BD, during a very important time for neurological, cognitive, emotional and academic development," conclude Duffy et al.

They add: "This observation underscores the importance of further research to determine who in this vulnerable population develops SUD, and how this differs initially or at all from SUD in the general adolescent population.

"This information would then lend itself to the development of specific early and perhaps preventative interventions targeting the underpinnings of SUD in HR populations, and may have relevance for prevention in the adolescent general population."

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