Risk of substance use disorders in adolescents with bipolar disorder

Timothy E. Wilens, Joseph Biederman, Anne Kwon, Jeffrey Ditterline, Peter Forkner, Hadley Moore, Allison Swezey, Lindsey Snyder, Aude Henin, Janet Wozniak, Stephen V. Faraone

Research output: Contribution to journalArticlepeer-review

106 Scopus citations


Objective: Previous work in adults and youths has suggested that juvenile onset bipolar disorder (BPD) is associated with an elevated risk of substance use disorders (SUD). Considering the public health importance of this issue, the authors now report on a controlled study of adolescents with and without BPD to evaluate the risk of SUD. Method: Probands with DSM-IV BPD (n = 57, mean age ± SD = 13.3 ± 2.4 years) and without DSM-IV BPD (n = 46, 13.6 ± 2.2 years) were studied. Structured psychiatric interviews and multiple measures of SUD were collected. Results: Bipolar disorder was associated with a highly significant risk factor for SUD (32% versus 7%, Z = 2.9, p = .004) that was not accounted for by conduct disorder (adjusted odds ratio = 5.4, p = .018). Adolescent-onset BPD (≥13 years) was associated with a higher risk of SUD compared with those with child-onset BPD (χ21 = 9.3, p = .002). Conclusions: These findings strongly indicate that BPD, especially adolescent onset, is a significant risk factor for SUD independently of conduct disorder.

Original languageEnglish
Pages (from-to)1380-1386
Number of pages7
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Issue number11
StatePublished - Nov 2004
Externally publishedYes


  • Bipolar disorder
  • Mania
  • Substance abuse


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