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Acta Psychiatr Scand. 2010 Jun;121(6):437-45. doi: 10.1111/j.1600-0447.2009.01498.x. Epub 2009 Nov 5.

Impact of substance use on the physical health of patients with bipolar disorder.

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Department of Psychiatry, University of Oviedo, Oviedo, Spain.



To describe the impact of tobacco, alcohol and cannabis on metabolic profile and cardiovascular risk in bipolar patients.


Naturalistic, cross-sectional, multicenter Spanish study. Current use of tobacco, alcohol and cannabis was determined based on patient self-reports. Metabolic syndrome was defined using the National Health and Nutrition Examination Survey 1999-2000 and the American Heart Association/National Heart, Lung and Blood Institute criteria, and cardiovascular risk using the Framingham and the Systematic Coronary Risk Evaluation functions.


Mean age was 46.6 years, 49% were male. Substance use: 51% tobacco, 13% alcohol and 12.5% cannabis. Patients who reported consuming any substance were significantly younger and a higher proportion was male. After controlling for confounding factors, tobacco was a risk factor for coronary heart disease (CHD) (unstandardized linear regression coefficient 3.47, 95% confidence interval 1.85-5.10).


Substance use, mainly tobacco, was common in bipolar patients. Tobacco use negatively impacted CHD risk.

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