P.5.030 Substance use disorders and their treatment response in dual diagnosis bipolar disorder

Despite ongoing controversy, the view that pediatric mania is rare or non-existent has been increasingly challenged not only by case reports but also by systematic research. This research strongly suggests that pediatric mania may not be rare but that it may be difficult to diagnose. Since children with mania are likely to become adults with bipolar disorder, the recognition and characterization of childhood-onset mania may help identify a meaningful developmental subtype of bipolar disorder worthy of further investigation. The major difficulties that complicate the diagnosis of pediatric mania include:- its pattern of comorbidity may be unique by adult standards, especially its overlap with ADHD, aggression and conduct disorder;- its overlap with substance use disorders;- its association with trauma and adversity;- its response to treatment is atypical by adult standards.These issues will be reviewed in the presentation.

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The Duration of Undiagnosed Bipolar Disorder: Impact of Substance use Disorders co-morbidity

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1950 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S132-S132

Author(s):

S. Ben Mustapha ◽

W. Homri ◽

L. Jouini ◽

R. Labbane

Keyword(s):

Bipolar Disorder ◽

Substance Use ◽

Standard Deviation ◽

Substance Use Disorders ◽

Mood Stabilizer ◽

Type I ◽

Addictive Behaviour ◽

Bipolar Disease ◽

Co Morbidity ◽

The Impact

AimsStudy the impact of substance use disorders (SUD) co-morbidity on the duration of undiagnosed bipolar disorder (DUBP).MethodsCase-control study during a period of six months from July 2015 to December 2015. One hundred euthymic patients with BD (type I, II or unspecified) were recruited in the department of psychiatry C Razi Hospital, during their follow-up. Two groups were individualized by the presence or not of a SUD co-morbidity. In our study DUBP was defined as the period between the first symptoms and the beginning of treatment by a mood stabilizer.ResultsThe beginning of addictive behaviour preceded the installation of bipolar disease in 32% of cases. Installation of bipolar disorder preceded the installation of addictive behaviour in 12% of cases. The beginning of addictive behaviour was concomitant with the installation of bipolar disease in 6% of cases. The average DUBP in the full sample was 4.80 years with a standard deviation of 8.04 and extremes ranging from 0.08 to 37.5.The average DUBP in patients with SUD co-morbidity was 5.91 years with a standard deviation of 8.16 and extremes ranging from 0.08 to 35, and 3.68 years with a standard deviation of 7.84 and extremes ranging from 0.08 to 37.5 in patients without SUD co-morbidity.ConclusionsAccording to studies over two thirds of patients with bipolar disorder received misdiagnoses before diagnosis of BD, and among the factors involved can report the presence of SUD co-morbidity. Hence, we should detect BD among patients with SUD.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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