Bipolar disorder has the highest rates of comorbid substance use disorders. Approximately 60% of patients with bipolar I disorder have a lifetime diagnosis of a substance use disorder (SUD). Excluding tobacco, alcohol is the substance most often abused, followed by cannabis, amphetamines and cocaine.

Determine the prevalence and compare sociodemographic and clinical variables in patients with SUD comorbid diagnoses and patients without this comorbidity.

Charts of all patients with a diagnosis of bipolar disorder admitted in the Coimbra Hospital and Universitary Center over a three-year period (2013–2015) were reviewed to gather data on sociodemographic and clinical data.

During a three-year period, 189 patients were admitted with bipolar disorder, almost half of patients (47,6%) had a SUD comorbid diagnostic. Comorbidity of BD and SUD is characterized by a complicated course with multiple recurrences of bipolar episodes and increased hospitalizations. The risk of suicide attempt is significantly higher when associated with SUD. In addition, BD is associated with pervasive social, family, and employment dysfunction. Poor treatment adherence in this population is also a serious clinical challenge that significantly impacts treatment response and outcome. The authors will analyze all this variables in the population admitted.

According to the most recent literature on SUD and BD, these two problems occur together so frequently that all patients with a bipolar diagnosis should also be assessed for drug and alcohol problems. BD complicated by SUD represents a serious public health problem and a major challenge to treatment providers.