Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, P.O. Box 980126, Richmond, VA, USA.
J Affect Disord. 2013 Sep 25;150(3):974-80. doi: 10.1016/j.jad.2013.05.023. Epub 2013 Jun 2.
Bipolar disorder is associated with substance use and misuse. However, to date few studies have examined the relationship between hypomania and substance misuse and dependence in the general population.
Data come from the National Institute of Mental Health Collaborative Psychiatric Epidemiology Surveys (CPES), a set of multi-stage area probability samples of US adults (N=10,404). Multivariable linear and logistic regression was used to assess the relationship between DSM-IV hypomania and nicotine, alcohol, cannabis, cocaine, and prescription drug use. Models were adjusted for age, gender, education, and marital status. Stratified analyses and interaction terms were used to determine whether the relationship between hypomania and substance misuse varied by race/ethnicity.
The 12-month prevalence of hypomania was 0.5%. Hypomania was more common among African Americans (0.9%) relative to non-Hispanic Whites (0.5%) or other race/ethnicities (0.7%). Individuals with hypomania were 3.6 (95% CI: 1.5, 8.5) and 2.9 (95% CI: 1.3, 6.8) times more likely to also meet criteria for alcohol abuse/dependence and drug abuse/dependence relative to individuals without. The relationship between hypomania and substance use outcomes did not vary by race/ethnicity.
The primary limitation of this study is its cross-sectional design, which precludes any inference about the causal nature of comorbid hypomania-substance use.
Hypomania is associated with increased likelihood of substance use and dependence/abuse across a broad range of substances. These associations were consistent across racial/ethnic groups. Findings indicate that even sub-syndromal conditions, such as hypomania, are significantly related to substance use and misuse in the community.
双相情感障碍与物质使用和滥用有关。然而，迄今为止，很少有研究调查普通人群中轻躁狂与物质滥用和依赖之间的关系。
数据来自美国国立精神卫生研究所合作精神流行病学调查（CPES），这是一组美国成年人的多阶段区域概率样本（N=10404）。采用多变量线性和逻辑回归评估 DSM-IV 轻躁狂与尼古丁、酒精、大麻、可卡因和处方药物使用之间的关系。模型调整了年龄、性别、教育程度和婚姻状况。分层分析和交互项用于确定轻躁狂与物质滥用之间的关系是否因种族/民族而异。
轻躁狂的 12 个月患病率为 0.5%。非裔美国人（0.9%）中轻躁狂的发生率高于非西班牙裔白人（0.5%）或其他种族/民族（0.7%）。与没有轻躁狂的个体相比，有轻躁狂的个体同时符合酒精滥用/依赖和药物滥用/依赖标准的可能性分别高出 3.6 倍（95%CI：1.5，8.5）和 2.9 倍（95%CI：1.3，6.8）。轻躁狂与物质使用结果之间的关系不因种族/民族而异。
本研究的主要局限性是其横断面设计，这排除了共患轻躁狂-物质使用的因果性质的任何推断。
轻躁狂与广泛的物质使用和依赖/滥用的可能性增加有关。这些关联在不同种族/民族群体中是一致的。研究结果表明，即使是亚综合征状态，如轻躁狂，与社区中的物质使用和滥用也有显著关系。
