Trastorno afectivo bipolar y trastorno por uso de sustancias. Prevalencia y factores asociados a la patología dual en población general de Colombia

Abstract

Introduction

Comorbidity between bipolar disorder (BD) and substance use disorder is relevant in the context of dual pathology due to its high prevalence and clinical and social implications. The objective of the study was to determine the prevalence of comorbid bipolar affective disorder with substance use disorder and associated sociodemographic and clinical factors in the general population.

Methodology

Analytical cross-sectional study, with a secondary source of information from a population study with 2,072 participants from 15 to 65 years of age interviewed with CIDI 3.0 (Composite International Diagnosis Interview); 23 mental disorders were diagnosed according to DSM-IV criteria. Sociodemographic and psychiatric clinical variables were included.

Results

Lifetime prevalence of BD and alcohol comorbidity (abuse 7.4%, dependence 9.7%); BD and drugs (abuse 6.5%, dependence 18.8%) and substance use disorder (including alcohol and drugs) 12.2%. After adjusting for clinical and sociodemographic variables in the multivariate model, alcohol abuse [RPa 6.60, 95%CI (1.54-28.26)], drug dependence [RPa 6.16, CI95% (1.38 -27.45)], oppositional defiant disorder [RPa 7.39, 95% CI (2.40-22.72)], and physical abuse [RPa 2.58 (1.01-6.58)].

Discussion

In the subgroup of people with BD, after controlling for confounding factors such as mental disorders and sociodemographic variables, a strong association with drug dependence and alcohol abuse was observed. Two additional risk factors emerge, childhood physical abuse and oppositional defiant disorder, which have previously been associated with poor mental health outcomes.

Conclusions

Detection of specific cohorts at risk of mental disorder is challenging. This study found that people diagnosed with BD throughout life are more vulnerable than others to having a substance use disorder.