MedWire News: Although it is common for individuals with mood disorders to self-medicate with alcohol and drugs in order to relieve symptoms, it is associated with significant psychiatric comorbidity, Canadian study findings indicate.
It has been suggested that the high comorbidity rates between anxiety and substance use disorders is explained by the use of alcohol or drugs as self-medication in order to reduce emotional distress. However, there has been little study of self-medication in mood disorders, despite equally high rates of alcohol and drug use.
James Bolton and colleagues from the University of Manitoba in Winnipeg therefore examined data from the nationally representative National Epidemiologic Survey on Alcohol and Related Conditions, involving 43,093 community dwelling adults.
In all, 2184 individuals had dysthymia, 7822 had major depressive disorder, 1546 had bipolar I disorder, 538 bipolar II disorder, and 8420 any mood disorder, the team notes in the Journal of Affective Disorders.
Overall, 24.1% of individuals with any mood disorder self-medicated with alcohol or drugs. Specifically, 22.9% of dysthymia patients, 23.2% of major depressive disorder patients, 41.0% of bipolar I disorder patients, and 34.7% of bipolar II disorder patients self medicated with these substances.
For bipolar disorder patients, self-medication was most prevalent during depressive episodes, at 40.8% and 32.2% for bipolar I and II disorder patients, respectively, compared with 28.4% during manic episodes, and just 8.2% during hypomanic symptoms.
Self-medication was significantly associated with male gender, being divorced or widowed, and being from the West census region, at odds ratios of 2.18, 1.47, and 1.36, respectively.
In addition, self-medication was inversely related to being aged 45–64 years or ≥65 years versus younger ages, at odds ratios of 0.76 and 0.28, respectively, as well as being Black, Asian/Hawaiian, or Hispanic versus being white, at respective odds ratios of 0.77, 0.52, and 0.58.
Self-medication was also significantly associated with comorbid panic disorder and dependent personality disorder among men, at odds ratios of 2.80 and 8.68, respectively, and with generalized anxiety disorder and dependent personality disorder among women, at respective odds ratios of 2.70 and 2.84.
The team concludes: “Clinicians should assess alcohol, drug, and prescription medication misuse in this population, as well as reasons for use, as this information may help identify a subgroup of mood disorder patients requiring greater services.”
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