Co-occurrence of bipolar disorder and personality disorders in the United States: Prevalence, suicidality, and the impact of substance abuse.

Journal: Journal of affective disorders

Volume: 345

Issue: 

Year of Publication: 2023

Affiliated Institutions:  Greater Manchester Mental Health National Health Service Foundation Trust, UK. University of Ibadan, College of Medicine, Oyo State, Nigeria. Ambrose Alli University, Ekpoma, Edo State, Nigeria. Jos University Teaching Hospital, Jos, Plateau State, Nigeria. Electronic address: frankdumelo@gmail.com. Rivers State University Teaching Hospital, Port Harcourt, Nigeria. All Saints University College of Medicine, Belair Kingstown, Saint Vincent and the Grenadines. Obafemi Awolowo University, Ile-Ife, Osun state, Nigeria. College of Medicine, University of Nigeria, Ituku-Ozalla, Enugu State, Nigeria. College of Medicine, University of Benin, Benin City, Edo State, Nigeria. St. Barnabas Hospital SBH Health System, Bronx, NY, USA. Federal Medical Center Abeokuta, Ogun state, Nigeria.

Abstract summary 

This study investigates prevalence rates of specific personality disorders (PDs) in individuals with bipolar disorder (BD) and their impact on substance abuse and suicidality, addressing existing gaps in the literature.Using Nationwide Inpatient Sample data (2016-2020), adult hospitalizations for BD with coexisting PDs were analyzed. Study variables were defined using ICD-10-CM codes. Prevalence of PD were reported as cases per 100,000 BD admissions. Regression models assessed the association between substance abuse and suicidality.About 993,000 admissions for BD were analyzed. The cohort was predominantly Caucasian (70.5 %) with higher female representation (54.5 %). The mean age was 41 years. 89.4 % of individuals had a Charlson Comorbidity Index score ≤ 1. The most common diagnostic subtype was manic episode of BD with or without psychotic features (32.3 %). Coexisting PDs were observed in 12.2 % of the population, with borderline PD (8.2 %) and antisocial PD (2.6 %) being most prevalent. Substance abuse was common (44.8 %), with cannabis (23.8 %), alcohol (19.4 %), cocaine (10.5 %), and opioids (9.6 %) being most reported. Substance abuse was higher in individuals with BD and PD (50 %) compared to BD alone (44.1 %). 596 suicide attempts were recorded (60 per 100,000 BD admissions). Substance abuse and coexisting PD in bipolar individuals elevated the likelihood of attempts (P < 0.001).Use of administrative data (retrospective, inpatient); treatment not studied.The study reveals a notable prevalence of PDs in individuals with BD, with increased likelihood of substance abuse and suicide attempts in those with coexisting BD and PD compared to BD alone.

Authors & Co-authors:  Anona Kenechukwu K Olaomi Oluwatobi O Udegbe Ebehireme E Uwumiro Fidelis F Tuaka Ebere-Bank EB Okafor Nnenna N Adeyinka Adebimpe A Obijuru Chinwendu C Okpujie Victory V Bojerenu Micheal M Opeyemi Mojeed M

Study Outcome 

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Statistics
Citations : 
Authors :  11
Identifiers
Doi : 10.1016/j.jad.2023.10.087
SSN : 1573-2517
Study Population
Female
Mesh Terms
Adult
Other Terms
Bipolar disorder;Depression;Mania;Personality disorders;Substance abuse;Suicide
Study Design
Study Approach
Country of Study
Publication Country
Netherlands