ADHD News & Research

Teens with Bipolar Disorder at Greater Risk for Drug Abuse

Though bipolar disorder in teens is not yet fully understood, a new study points towards an increased risk for substance abuse problems by the time teenagers with the condition reach adulthood.

September 6, 2016

Teenagers with bipolar disorder are nearly twice as likely as their peers to turn to drugs and alcohol in adulthood, a new study finds — particularly if their bipolar disorder is left untreated or has gotten worse.

A team of researchers affiliated with Massachusetts General Hospital followed up with 68 teenagers — now young adults — that had been diagnosed with bipolar disorder five years before. Over the five-year period, 49 percent of the teens had developed substance abuse problems or smoking habits, compared with just 26 percent of the general teenage population.

The risk was even higher for those whose bipolar symptoms had gotten worse, the researchers say. For patients who had found effective treatment or who had otherwise experienced remission of their bipolar disorder, the chances that they had developed a substance abuse problem were much lower. But even those whose symptoms had improved were still at greater risk than neurotypical teenagers, the researchers wrote.

Some comorbid conditions — but not all — further increased the risk for substance abuse. Teens who had also been diagnosed with conduct disorder, for example, had an increased risk for drug use, while teens with comorbid ADHD showed no increase.

“We were surprised to find that conduct disorder, but not ADHD, played such a large role in mediating the increased risk of substance use disorder among those with bipolar disorder,” said Dr. Timothy Wilens, chief of Child and Adolescent Psychiatry at the hospital. “While this might be result of having only a few participants with bipolar disorder alone, it may be that it is the presence of conduct disorder that drives substance use disorder as adolescents with bipolar disorder become young adults.”

The study’s small number of participants means that its conclusions are only preliminary, and will need to be confirmed with larger follow-up studies. But the implications are serious, the researchers say, and emphasize the need to treat bipolar disorder as soon as it has been properly diagnosed.

“Since symptoms of bipolar disorder usually appear before substance use disorder develops, clinicians following youth with bipolar disorder should carefully monitor for cigarette smoking and substance use, along with treating bipolar symptoms,” said Wilens.

The study was published online August 30 in The Journal of Clinical Psychiatry.