Category: Bipolar Disorders

PS3- #B55 - Lifetime Substance Use Disorders Do Not Predict Likelihood of Recovery and Time to Recovery in the STEP-BD Psychosocial Trial

Friday, Nov 17
11:00 AM – 12:00 PM
Location: Indigo Ballroom CDGH, Level 2, Indigo Level

Keywords: Bipolar Disorder | Substance Abuse | Comorbidity

Substance use disorders (SUDs) are common in bipolar disorder (BD) with estimated prevalence rates ranging from 20-56%. Comorbid SUDs are associated with greater likelihood of disability, mortality, and recurrent course of illness, magnifying the economic burden of the disease. Understanding how substance use comorbidity impacts the effectiveness of existing treatments could aid in the development of more targeted, efficient, and cost-effective interventions for patients with comorbid SUDs in BD. We examined the impact of comorbid SUDs on psychosocial treatment outcome in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) psychosocial trial. Adult patients with BD (n = 268) who had one or more psychiatric comorbidities were randomly assigned to receive 30 sessions of intensive psychotherapy (cognitive-behavioral therapy, family-focused treatment, or interpersonal and social rhythm therapy) or 3 sessions of a psychoeducation-based intervention (collaborative care). Information on past SUDs (in this sample, alcohol use disorders and drug use disorders) was collected at baseline via the Mini International Neuropsychiatric Interview. Participants were designated “recovered” if they had 2 or fewer moderate mood symptoms for 8 or more consecutive weeks. We conducted logistic regression analyses to assess likelihood of recovery and cox regression analyses to assess time to recovery from a depressive episode. 54.5% of participants (n = 146) met criteria for a lifetime SUD. Among participants with a lifetime SUD, 63% (n = 92) achieved recovery. Lifetime SUDs did not predict likelihood of recovery (B = .30, p = .23) or time to recovery (B = .20, p = .21) from a depressive episode. Patients with a lifetime comorbid SUD were not less likely to recover and did not take a longer time to recover than patients without a lifetime comorbid SUD. Future analyses in this sample should assess whether certain illness characteristics (e.g., demographic features, pharmacotherapy) impact recovery in BD patients with lifetime comorbid SUDs.


Alexandra K. Gold

Clinical Research Coordinator
Boston University
Waban, Massachusetts

Amy T. Peters

University of Illinois at Chicago

Louisa G. Sylvia

Assistant Professor
Massachusetts General Hospital, Harvard Medical School
Boston, Massachusetts

Pedro Vieira da Silva Magalhaes

Universidade Federal de Rio Grande de Sul

Michael Berk

Deakin University

Darin D. Dougherty

Associate Professor of Psychiatry
Massachusetts General Hospital, Harvard Medical School

Michael W. Otto

Boston University

Michael W. Otto, PhD, is Professor in the Department of Psychological and Brain Sciences at Boston University. He has had a major career focus on developing and validating new psychosocial treatments for anxiety, mood, psychotic, and substance use disorders, with a particular focus on treatment refractory populations. This includes a translational research agenda investigating brain-behavior relationships in therapeutic learning. His focus on hard-to-treat conditions and principles underlying behavior-change failures led him to an additional focus on health behavior promotion, including investigations of addictive behaviors, medication adherence, sleep, and exercise. Across these health behaviors, he has been concerned with cognitive, attention, and affective factors that derail adaptive behaviors, and the factors that can rescue these processes. He also investigates exercise as an intervention for affective and addictive disorders, as well as for cognitive enhancement. He has over 400 publications spanning his research interests, and was identified as a “top producer” in the clinical empirical literature, and an ISI Highly Cited Researcher. He is a Past President of the Association of Behavioral and Cognitive Therapies, and is currently President of Division 12 of the American Psychological Association.

Andrew A. Nierenberg

Professor of Psychiatry
Massachusetts General Hospital, Harvard Medical School

Thilo Deckersbach

Associate Professor of Psychology in the Department of Psychiatry
Massachusetts General Hospital
Boston, Massachusetts