Specificity of Bipolar Spectrum Conditions in the Comorbidity of Mood and Substance Use Disorders

Merikangas, Kathleen R.; Herrell, Richard; Swendsen, Joël; Rössler, Wulf; Ajdacic-Gross, Vladeta; Angst, Jules

doi:10.1001/archgenpsychiatry.2007.18

Cited by 168 publications

(124 citation statements)

References 58 publications

(83 reference statements)

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“…However, the overall figures for abstinence and drinks per drinking day suggest that the groups can be treated together in a dual diagnosis programme and that benefits continue after discharge. There is recent evidence for differences between depression and bipolar disorder based upon the characteristics of the depressive episodes (Mitchell et al, 2011) as well as obvious syndromal characteristics (DSM-IV), but many reports emphasize the similarities between the two disorders (Akiskal et al, 1995;Angst et al, 2010;Smith et al, 2011), particularly in situations of co-morbidity with substance use disorders (Merikangas et al, 2008) suggesting the possibility of a spectrum disorder (Smith et al, 2008). Overall, this study suggests that their psychoeducational and addiction treatments may be undertaken together successfully.…”

Section: Discussionmentioning

confidence: 69%

Prognostic Factors of 2-year Outcomes of Patients with Comorbid Bipolar Disorder or Depression with Alcohol Dependence: Importance of Early Abstinence

Farren

Snee

Daly

et al. 2012

Alcohol and Alcoholism

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-Aims: To investigate the prognostic factors that determine 2-year outcomes in a group of alcohol-dependent patients with depression or bipolar disorder who were treated in an intensive 4-week inpatient programme. Methods: This was a longitudinal study of an inpatient treatment cohort of dual affective disorder and alcohol-dependent patients, in Dublin, Ireland. Measurements included baseline demographics with follow-up measurements at discharge, 3 months, 6 months and 2 years after treatment, including alcohol consumption, depression, mania/elation, anxiety, craving, drug use and sample blood tests. Factor and regression analysis of multiple variables was carried out to predict outcomes. Results: A total of 189 participants with alcohol dependence and comorbid depression (n = 101) or bipolar disorder (n = 88) were followed over 2 years after discharge from treatment. Retention rate was 76% over 2 years. Early abstinence (at 6 months) predicted better abstinence overall at 2 years; and bipolar alcoholics had a better outcome in drinks per drinking day than depressed alcoholics at 2 years. Younger participants (age 18-30 years) did relatively worse than middle-age (30-50 years) and older (51 + years) participants in measures of abstinence and number of drinks per drinking day at 2 years; and females did better than males in number of drinks per drinking day at 2 years. Conclusion: Dual diagnosis of alcohol dependence and depression or bipolar disorder may be treated together with intensive intervention and follow-up, and various prognostic factors including early abstinence emerge over time that influence outcomes over 2 years.

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Section: Discussionmentioning

confidence: 69%

Prognostic Factors of 2-year Outcomes of Patients with Comorbid Bipolar Disorder or Depression with Alcohol Dependence: Importance of Early Abstinence

Farren

Snee

Daly

et al. 2012

Alcohol and Alcoholism

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“…Similar to prior high risk studies of BPD, we found an elevated risk of SUD, particularly alcohol use disorders, among offspring of probands with BPD, but not MDD. The prospective data demonstrating an increased risk of alcohol dependence among community adults with BPD (Merikangas et al, 2008) highlight the potential benefit of prevention of alcohol dependence through intervention in youth with early manifestations of BPD. The other non-affective disorder associated with parental BPD was childhood SAD, replicating the findings of an earlier prospective community study of youth (Bruckl et al, 2007) which found a 7-fold increased risk of BPD among youth with earlier SAD.…”

Section: Discussionmentioning

confidence: 99%

The specificity of the familial aggregation of early-onset bipolar disorder : A controlled 10-year follow-up study of offspring of parents with mood disorders

Preisig

Strippoli

Castelao

et al. 2016

Journal of Affective Disorders

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Background: Two major sources of heterogeneity of mood disorders that have been demonstrated in clinical, family and genetic studies are the mood disorder subtype (i.e. bipolar (BPD) and major depressive disorder (MDD)) and age of onset of mood episodes. Using a prospective high-risk study design, our aims were to test the specificity of the parent-child transmission of BPD and MDD and to establish the risk of psychopathology in offspring in function of the age of onset of the parental disorder. Methods:Clinical information was collected on 208 probands (n=81 with BPD, n=64 with MDD, n=63 medical controls) as well as their 202 spouses and 372 children aged 6-17 years at study entry.Parents and children were directly interviewed every 3 years (mean duration of follow-up = 10.6 years). Parental age of onset was dichotomized at age 21. Results:Offspring of parents with early onset BPD entailed a higher risk of BPD HR=7.9(1.8-34.6) and substance use disorders HR=5.0(1.1-21.9) than those with later onset and controls. Depressive disorders were not significantly increased in offspring regardless of parental mood disorder subtype or age of onset.Limitations: limited sample size, age of onset in probands was obtained retrospectively, age of onset in co-parents was not adequately documented, and a quarter of the children had no direct interview. Conclusions:Our results provide support for the independence of familial aggregation of BPD from MDD and the heterogeneity of BPD based on patterns of onset. Future studies should further investigate correlates of early versus later onset BPD.

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“…This implicates a link between mood disorders and substance abuse or dependence disorders and a genetic link between alcoholism and bipolar disorder has been suggested (Brady and Lydiard, 1992;Sonne and Brady, 2002;Merikangas and Gelemter, 1990;Merikangas et al, 2008). Individuals with manic symptoms may be at greater risk for the later onset of alcohol and cannabis dependence.…”

Section: A Link Between Mood Disorders and Substance Abusementioning

confidence: 91%

Type 2 diabetes mellitus, drug addiction, bipolar disorder and epilepsy display overlapping aetiopathogenic mechanisms: Implication for prevention and pharmacotherapy

Oriaifo¹

2015

J. Med. Med. Sci

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The prevalence of diabetes and co-morbid diseases, especially in developing countries, may have already exceeded estimates. Accumulating reports indicate considerable underpinnings in the mechanisms of the aetiopathogenesis of metabolic syndrome, bipolar disorder, epilepsy and, recently, substance addiction. Continuing evidence incriminates dysfunction in genetic, mitochondrial and inflammatory cascade mechanisms as contributory factors to the dysregulation of neurotrophic, serotonergic, dopaminergic, adrenergic, glutamatergic, GABAergic and autophagic pathways. There may also be co-incident dysregulation of the global anti-oxidant network, the endogenous digitalis system, the vasopressin signalling and the hypothalamo-pituitary-adrenal axis. Nuclear factor-kappa B (NF-kappa B) signaling and reactive oxygen species lead to activation of the mammalian target of rapamycin complex I (mTORCI) and this process may be central to the aetiopathogenesis of drug addiction, obesity, foetal programming, diabetes mellitus, epilepsy and bipolar disorder. Antiglycaemics such as cannabinoid CB2 agonists, metformin, artesunate and valproate; insulin-mimetics such as glucagon-like peptide-I (GLP-I) and its analogues; phytomedicines from garlic and curcumin are now shown to exhibit neuroprotective effects. These agents which may down-regulate inflammatory cytokines, upregulate endothelial nitric oxide (eNOS) and peroxisome proliferator-activated receptor alpha (PPAR-α) signalling, attenuate mitochondrial dysfunction, enhance the actions of glucagon-like peptide-I (GLP-I), inhibit mTOR, NF-kappa B, interleukin-I β and glycogen synthase kinase-3 β stand to be of benefit in these illnesses which demonstrate considerable overlay in their aetopathogenic mechanisms. Underpinnings and bidirectional relationships between the metabolic syndrome and mental health disorders may pave way for common new fronts to drug development in translational cardiovascular psychiatry and neurology.

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Specificity of Bipolar Spectrum Conditions in the Comorbidity of Mood and Substance Use Disorders

Cited by 168 publications

References 58 publications

Prognostic Factors of 2-year Outcomes of Patients with Comorbid Bipolar Disorder or Depression with Alcohol Dependence: Importance of Early Abstinence

Prognostic Factors of 2-year Outcomes of Patients with Comorbid Bipolar Disorder or Depression with Alcohol Dependence: Importance of Early Abstinence

The specificity of the familial aggregation of early-onset bipolar disorder : A controlled 10-year follow-up study of offspring of parents with mood disorders

Type 2 diabetes mellitus, drug addiction, bipolar disorder and epilepsy display overlapping aetiopathogenic mechanisms: Implication for prevention and pharmacotherapy

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