Researchers from Massachusetts General Hospital (MGH) say that adolescents with bipolar disorder are more likely to use alcohol, tobacco and other drugs.

The study compared 105 adolescents with diagnosed bipolar disorders to a control group of 98 youths with no mood disorders and found that 34 percent of the bipolar group smoked or were dependent upon alcohol or other drugs, compared to 4 percent of the control group. High rates of alcohol, tobacco and other drug use persisted even when researchers controlled for co-occurring behavioral and psychiatric conditions.

"This work confirms that bipolar disorder in adolescents is a huge risk factor for smoking and substance abuse, as big a risk factor as is juvenile delinquency," said lead researcher Timothy Wilens, M.D., director of Substance Abuse Services in MGH Pediatric Psychopharmacology. "It indicates both that young people with bipolar disorder need to carefully be screened for smoking and for substance use and abuse and that adolescents known to abuse drugs and alcohol -- especially those who binge use -- should also be assessed for bipolar disorder."

Most subjects developed bipolar disorder before initiating alcohol, tobacco, or other drug use, researchers found. "It could be that the onset of mood dysregulation in adolescence puts kids at even higher risk for poor judgment and self-medication of their symptoms," Wilens said. "It also could be that some genetic switch activated in adolescence turns on both BPD and substance abuse in these youngsters. That's something that we are currently investigating in genetic and neuroimaging studies of this group."

The study appears in the June 2008 issue of the journal Drug and Alcohol Dependence.