Substance Use Is a Risk Factor for Violent Behavior in Male Patients with Bipolar Disorder
BACKGROUND:
To
determine the factors involved in violent behavior in patients with bipolar
disorder (BD) and to investigate the relationship between violence and
substance use disorder (SUD).
METHODS:
A sample
of 100 male inpatients diagnosed with BD type I who were experiencing a current
mood episode participated in the study. Violent behavior was defined as
physical aggression against others. All patients were evaluated using the Young
Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HDRS), Positive
and Negative Syndrome Scale-positive subscale (PANSS-p), Barratt Impulsivity
Scale-11 (BIS-11), Buss-Perry Aggression Questionnaire (BPAQ) and Overt
Aggression Scale (OAS). Lifetime SUD and current use of substances were
evaluated. Logistic regression analysis was conducted to predict violent
behavior.
RESULTS:
Current
substance use (CSU) rather than lifetime SUD was found to be related to violent
behavior in patients with BD, and CSU was associated with a threefold increase
in the risk of violence. The rate of lifetime SUD in our sample was 59%, and
the rate of CSU was 39%. The most commonly abused substances were cannabis and
alcohol, followed by synthetic cannabinoids, in both groups of patients with
lifetime SUD and CSU. Individuals abusing any substance were more likely to
have a criminal record and history of incarceration than other patients. One of
the most significant risk factors for violence was a previous history of
violent behavior.
LIMITATIONS:
The
sample was limited to male patients. Data on some participants' recent
substance use from standard urine analysis was not obtained. The data on the
use of synthetic cannabinoids was obtained from patients and their families
owing to the lack of equipment for detecting synthetic cannabinoids using
laboratory analysis.
CONCLUSIONS:
CSU
appears to be a significant predictive factor in violent behavior in male
patients. Further investigation of co-occurrence of violence with CSU and
improvement in treatment strategies might reduce or prevent violence in
patients with BD.
- 1Bakırköy Prof. Dr. Mazhar Osman Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, Turkey. Electronic address: dr_izgi@hotmail.com.
- 2Bakırköy Prof. Dr. Mazhar Osman Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, Turkey. Electronic address: muraterkiran@gmail.com.
- 3İstanbul Gelişim University, Department of Psychology, Turkey. Electronic address: elifmutlu@yahoo.com.
- J Affect Disord. 2015 Dec 30;193:89-93. doi: 10.1016/j.jad.2015.12.059.
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