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Screening for bipolar disorder among outpatients with substance use disorders

Published online by Cambridge University Press:  02 October 2011

A. Nallet ,
B. Weber ,
S. Favre ,
M. Gex-Fabry ,
R. Voide ,
F. Ferrero ,
D. Zullino ,
Y. Khazaal  and
J.M. Aubry
A. Nallet
Affiliation:
Geneva University Hospital, Department of Mental Health and Psychiatry, Service of General Psychiatry, Bipolar Program, 6-8, rue du 31-Décembre, 1207Geneva, Switzerland
B. Weber
Affiliation:
Geneva University Hospital, Department of Mental Health and Psychiatry, Service of General Psychiatry, Bipolar Program, 6-8, rue du 31-Décembre, 1207Geneva, Switzerland
S. Favre
Affiliation:
Geneva University Hospital, Department of Mental Health and Psychiatry, Service of General Psychiatry, Bipolar Program, 6-8, rue du 31-Décembre, 1207Geneva, Switzerland
M. Gex-Fabry
Affiliation:
Geneva University Hospital, Department of Mental Health and Psychiatry, Service of General Psychiatry, 2, chemin du Petit-Bel-Air, 1225Chêne-Bourg, Switzerland
R. Voide
Affiliation:
Geneva University Hospital, Department of Mental Health and Psychiatry, Service of General Psychiatry, Bipolar Program, 6-8, rue du 31-Décembre, 1207Geneva, Switzerland
F. Ferrero
Affiliation:
Geneva University Hospital, Department of Mental Health and Psychiatry, Service of General Psychiatry, 2, chemin du Petit-Bel-Air, 1225Chêne-Bourg, Switzerland
D. Zullino
Affiliation:
Geneva University Hospital, Department of Mental Health and Psychiatry, Service of Addictology, 2, rue Verte, 1205Geneva, Switzerland
Y. Khazaal
Affiliation:
Geneva University Hospital, Department of Mental Health and Psychiatry, Service of Addictology, 2, rue Verte, 1205Geneva, Switzerland
J.M. Aubry*
Affiliation:
Geneva University Hospital, Department of Mental Health and Psychiatry, Service of General Psychiatry, Bipolar Program, 6-8, rue du 31-Décembre, 1207Geneva, Switzerland
*
⁎Corresponding author. Tel.: +41 22 305 45 38; fax: +41 22 305 45 99. E-mail address:[email protected] (J.M. Aubry).
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Abstract

Background

Comorbidity of bipolar disorder and alcohol or substance abuse/dependence is frequent and has marked negative consequences on the course of the illness and treatment compliance. The objective of this study was to compare the validity of two short instruments aimed at screening bipolar disorders among patients treated for substance use disorders.

Methods

The Mood Disorder Questionnaire (MDQ) and the Hypomania Checklist-32 (HCL-32) were tested with reference to the mood section of the Structured Clinical Interview for DSM-IV axis I disorders (SCID) in 152 patients, recruited in two outpatient clinics providing specialized treatment for alcohol and opiate dependence.

Results

According to the SCID, 33 patients (21.7%) had a diagnosis within the bipolar spectrum (two bipolar I, 21 bipolar II and 10 bipolar not otherwise specified). The HCL-32 was more sensitive (90.9% vs. 66.7%) and the MDQ more specific (38.7% vs. 77.3%) for the whole sample. The MDQ displayed higher sensitivity and specificity in patients treated for alcohol than for opiate dependence, whereas the HCL-32 was highly sensitive but poorly specific in both samples. Both instruments had a positive predictive value under 50%.

Conclusions

Caution is needed when using the MDQ and HCL-32 in patients treated for substance use disorders.

Keywords

MDQHCL-32ComorbidityBipolar type I and IIAlcohol dependenceOpiate dependence
Type
Original article
Information
European Psychiatry , Volume 28 , Issue 3 , March 2013 , pp. 147 - 153
Copyright
Copyright © European Psychiatric Association 2011

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