Manic-Depressive Psychosis and DRug Abuse

Abstract

Many publications explore the causal relationship between psychiatric illness and drug abuse, but less information is available regarding the complications encountered in the diagnoses and management. Manic-depressive psychoses are reported by several authors to be underdiagnosed, and some cases may actually present a picture of alcoholism. The presence of manic-depressives among drug abusers is demonstrated in this report, and case summaries of manic-depressive patients with variable patterns of drug abuse are presented. Patterns of drug abuse as self-medication or as part of an identification process are observed; however, a controlled experimentation independent of the cyclic pattern of the illness is possible. Availability appears to be the important social determinant as to the type of drug taken.

The epidemiology of DSM-III-R bipolar I disorder in a general population survey

“…It is unclear why anxiety disorders should predispose to this type of bipolar disorder, but both genetic and environmental mechanisms are possibilities worthy of future consideration. The finding that cocaine use and stimulant use disorders predict subsequent bipolar disorder is consistent with the suggestion of several authors that drugs can precipitate bipolar illness (El-Guebaly, 1975 ;Weller et al 1988) as well as with the finding of Post et al (1986) that cocaine is a powerful inducer of kindling, a sensitizationlike process that may be a model for the development of bipolar illness. The findings that conduct disorder (CD) and adult antisocial behaviour (AAB) are associated with a significantly increased risk of subsequent mania are, at least superficially, consistent with the findings regarding the effects of drug use disorders.…”