Why should alcohol and substance abuse be included in the differential diagnosis of bipolar affective disorder (manic-depressive illness)?

Updated: May 30, 2019
  • Author: Stephen Soreff, MD; Chief Editor: Glen L Xiong, MD  more...
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Alcohol abuse and abuse of a wide variety of drugs can present as either mania or depression. For example, speed (ie, amphetamines) and cocaine abuse can present as a manialike disorder, and barbiturate abuse can present as a depressionlike disorder.

A number of patients with bipolar disorder, or manic-depressive illness (MDI), also have a drug or alcohol addiction; that is, they have dual diagnoses. Indeed, relative to other mental illnesses, individuals with bipolar disorder have a disproportionately high rate of substance use disorders, a co-occurrence that is associated with significant morbidity and mortality. [74]

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