ABSTRACT
Bipolar and substance use disorders frequently coexist. In a literature review on the subject, Brady and Lydiard1 estimated that alcohol or drug problems occur in 21% to 58% of patients with bipolar disorder. More recently, Keck and colleagues2 found that of 106 bipolar patients who were followed for 12 months after hospitalization for either a manic or a mixed-mood episode, 55% met criteria for a substance use disorder. Comorbidity between these two disorders is associated with a worse prognosis than with either diagnosis alone, including slower recovery time3and more psychiatric hospitalizations.4
