Aggression and substance abuse in bipolar disorder

Michael F. Grunebaum, Hanga C. Galfalvy, C. Matthew Nichols, Nathilee A. Caldeira, Leo Sher, Kanita Dervic, Ainsley K. Burke, J. John Mann, Maria A. Oquendo

Research output: Contribution to journalArticlepeer-review

47 Citations (Scopus)


Objectives: The goal of this retrospective study was to examine factors differentiating persons with bipolar disorder who did or did not have comorbid lifetime substance use disorders (SUD) at an index assessment. We also explored the chronology of onset of mood and SUD. Methods: We studied 146 subjects with DSM-defined bipolar disorder. Subgroups with and without lifetime SUD were compared on demographic and clinical measures. Results: Substance abuse disorders in this bipolar sample were associated with male sex, impulsive-aggressive traits, comorbid conduct and Cluster B personality disorders, number of suicide attempts and earlier age at onset of a first mood episode. In a multivariable logistic regression analysis, male sex and aggression and possibly earlier age at mood disorder onset were associated with SUD. In those with or without SUD, the first mood episode tended to be depressive and to precede the onset of SUD. Conclusions: In persons with bipolar disorder, an earlier age of onset and aggressive traits appear to be factors associated with later development of comorbid SUD.

Original languageEnglish
Pages (from-to)496-502
Number of pages7
JournalBipolar Disorders
Issue number5 I
Publication statusPublished - Oct 2006
Externally publishedYes


  • Aggression
  • Bipolar disorder
  • Depression
  • Impulsivity
  • Mania
  • Substance abuse

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry


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