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Substance use disorders in bipolar patients with a painful expression

Published online by Cambridge University Press:  19 July 2023

J. Chabert ,
R. Icick ,
J. Cabé ,
M.-C. Patoz ,
X. Moisset ,
O. Godin ,
S. Gard ,
J. Loftus ,
V. Aubin  and
R. Belzeaux
...Show all authors
J. Chabert*
Affiliation:
1CHU Clermont-Ferrand, Université Clermont Auvergne, Institut Pascal, Clermont Ferrand
R. Icick
Affiliation:
2CHU Lariboisière-Fernand Widal, INSERM UMRS 1144, Université de Paris Cité, Paris
J. Cabé
Affiliation:
3CHU Clermont-Ferrand, University of Clermont Auvergne, Institut Pascal
M.-C. Patoz
Affiliation:
1CHU Clermont-Ferrand, Université Clermont Auvergne, Institut Pascal, Clermont Ferrand
X. Moisset
Affiliation:
4CHU Clermont-Ferrand, Université Clermont Auvergne, Institut Pascal, Clermont-Ferrand
O. Godin
Affiliation:
5Fondamental Fondation, Créteil
S. Gard
Affiliation:
6Hospitalier Charles Perrens, INRAE UMR 1286, University of Bordeaux, Bordeaux, France
J. Loftus
Affiliation:
7Center Hospitalier Princesse Grace, Monaco
V. Aubin
Affiliation:
8Centre Hospitalier Princesse Grace, Monaco
R. Belzeaux
Affiliation:
9AP-HM, INT-UMR7289, Aix-Marseille Université, Marseille, France
C. Dubertret
Affiliation:
10Université de Paris, INSERM UMR1266, Hôpital Louis Mourier, Colombes
Y. Lestrat
Affiliation:
10Université de Paris, INSERM UMR1266, Hôpital Louis Mourier, Colombes
N. Mazer
Affiliation:
10Université de Paris, INSERM UMR1266, Hôpital Louis Mourier, Colombes
A. De Premorel
Affiliation:
10Université de Paris, INSERM UMR1266, Hôpital Louis Mourier, Colombes
P. Roux
Affiliation:
11Equipe DisAP-PsyDev, Université Versailles Saint-Quentin-en-Yvelines - Paris-Saclay, Villejuif
M. Polosan
Affiliation:
12Université Grenoble Alpes, CHU Grenoble, Grenoble Institut des Neurosciences (GIN) Inserm U 1216, Grenoble
T. Schwitzer
Affiliation:
13Université de Lorraine, Inserm U 1254, CHU Nancy, Laxou
B. Aouizerate
Affiliation:
14Hospitalier Charles Perrens, INRAE UMR 1286, Université de Bordeaux, Bordeaux
B. Isabelle
Affiliation:
15CHU Lariboisière-Fernand Widal, Paris
B. Etain
Affiliation:
2CHU Lariboisière-Fernand Widal, INSERM UMRS 1144, Université de Paris Cité, Paris
R. Moirand
Affiliation:
16INSERM U1028; CNRS UMR5292; University Lyon 1, Villeurbanne,. ΨR2 Team, CH Le Vinatier, Bron
E. Olié
Affiliation:
17Lapeyronie CHU Montpellier, Institut de Génomique Fonctionnelle, Université de Montpellier, Montpellier
E. Haffen
Affiliation:
18CIC-1431 INSERM, CHU de Besançon, Besançon
M. Leboyer
Affiliation:
19CHU Henri Mondor, Université Paris Est Créteil, INSERM U955, Créteil
P. Courtet
Affiliation:
20Lapeyronie CHU Montpellier, Montpellier, France
P.-M. Llorca
Affiliation:
4CHU Clermont-Ferrand, Université Clermont Auvergne, Institut Pascal, Clermont-Ferrand
G. Brousse
Affiliation:
4CHU Clermont-Ferrand, Université Clermont Auvergne, Institut Pascal, Clermont-Ferrand
L. Samalin
Affiliation:
4CHU Clermont-Ferrand, Université Clermont Auvergne, Institut Pascal, Clermont-Ferrand
*
*Corresponding author.

Abstract

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Introduction

Bipolar Disorder (BD) is a common psychiatric disease. It has been demonstrated a long time ago that bipolar patients are more painful than the healthy subjects. Substance use disorder is a frequent comorbidity in BD, but also in painful patients. The aim of our study was to analyze if bipolar patients with a painful expression have more substance use disorder than bipolar patients without pain.

Objectives

The aim of our study was to analyze if bipolar patients with a painful expression have more substance use disorder than bipolar patients without pain

Methods

We included all bipolar patients from the FACE-BD cohort which is a prospective cohort of French outpatients with BD enrolled at the 12 advanced Centers of Expertise in Bipolar Disorder (CEBD). Pain has been evaluated by the “pain item” of the EQ-5D scale and we divided subjects in four categories: “no pain”, “slight pain”, “moderate pain”, “severe or extreme pain”. A multivariate analysis was performed to identify differences between each pain’s groups according to the kind of substance use disorder, psychiatric comorbidities and clinicals data.

Results

The cohort enrolled 1897 bipolar patients, 970 had no pain (51.1%), 507 had slight pain (26.7%), 298 had moderate pain (15.7%) and 122 had severe or extreme pain (6.4%). We found significant differences according to age, comorbidities and clinicals data with older, more anxious, and more severe patients more represented in the more painful groups. Painful bipolar patients had also more frequently lifetime substance use disorders (alcohol, opioid, sedative, marijuana) and we were able to characterize different profiles in bipolar patients.

Conclusions

Bipolar patients with a painful expression had more risks to have a lifetime substance use disorder, an anxiety disorder, and a higher score on MADRS. Interestingly, subjects seemed to prefer substances with anxiolytic or antalgic effects during the acute intoxication as alcohol, marijuana, opioid and sedatives.

Disclosure of Interest

None Declared

Type
Abstract
Information
European Psychiatry , Volume 66 , Special Issue S1: Abstracts of the 31st European Congress of Psychiatry , March 2023 , pp. S199 - S200
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association
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