COSIG CONFERENCE BROCHURE.pdf - Drexel University College ...

COSIG Co-Occurring Disorders Conference, Hershey PA, May 15-17, 2006
Suicide : Bipolar Disorder
• Lifetime risk = 15xs higher in bipolar
disorder than in general population
– Highest risk = young men in early phase of
illness who have made previous attempts or
who abuse alcohol
– Risk increased if psychotic and depressed
concurrent with mania
– Increased risk if abusing substances
• 10-19% commit suicide
– 79% of these suicides occurred while
depressed
Substance Induced Mood
Disorders
A disturbance in mood characterized by
either (or both) of the following: 1)
depressed mood r diminished interest and
pleasure in activities; or 2)elevated,
expansive or irritable mood.
Alcohol
inhalant
amphetamine opioid
cocaine
hallucinogen
phencyclidine
Other e.g. ecstasy,
Marijuana
Substance- Related Disorders
(Kessler et al. 1996)
• More than 60% of individuals with bipolar
disorder meet lifetime criteria for a
substance-related disorder
– Greater than in any other Axis 1 disorder
• 34-67% rate of major depression in
alcohol abusers
Substance Abuse Disorders
Cont’d
• It is one of the major factors in medication
noncompliance and suicidality.
• Symptoms of the disorders mimic each
other
• These individuals have a more difficult
course of illness and are the most
treatment resistant.
Substance Abuse Disorders
Cont’d
• In around 10% of persons with co-occurring
disorders the depression persists after acquiring
sobriety (Nunes et al.1993)
• Both disorders can exist independently of each
other in the same individual and treatment of the
mood disorder yields improvement in both
conditions (Zickler, 2000; Grant, 1999)
• Those persons with co-occurring disorders are
much more likely to seek treatment with resulting
higher costs (Druss & Rosenheck, 2000)
General Treatment Approaches
• Use evidence-based guidelines and
management tools for treating
• Medication
• Psychotherapy
– Integrated for co-occurring, including
individual and group
– Intensive outpatient
• Psychoeducation
• Self-help, including 12 step and Dual
Recovery
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