Psychosocial Functioning of People with Substance Abuse and Bipolar Disorders.

This study assessed whether a secondary diagnosis of a substance use disorder in hospitalized people with bipolar disorder was associated with poorer outcomes on self-reported measures of mood (Profile of Mood States), subjective distress (Behavior and Symptom Identification Scale), and coping resources (Coping Resources Inventory), and with specific patient characteristics. Sixty-two patients with bipolar disorder and a secondary diagnosis of a substance use disorder and 60 patients with only a bipolar disorder diagnosis participated. Patients with bipolar disorder and a secondary diagnosis of a substance use disorder perceived significantly more impairment on all three measures than did patients without the secondary diagnosis. Moreover, the background characteristics of a history of violence, past or current involvement with the criminal justice system, and not having an antipsychotic medication prescribed during hospitalization had the strongest association with having a secondary diagnosis of a substance use disorder among the characteristics examined. These findings suggest the existence of a subgroup of patients with substance abuse and bipolar disorders who have substantial psychosocial impairment and probably require more intense treatment.

Aftercare Compliance: Perceptions of People with Dual Diagnoses.

This descriptive study was designed to learn, from the perspective of dually diagnosed inpatients, what factors affect their maintenance of an aftercare program. Ten audio-recorded focus groups were conducted using a structured interview schedule; additionally, patients participated in structured brief individual interviews, and their medical records were reviewed for demographic data and chief complaints on admission. Despite the numerous obstacles encountered by this population intrapersonally, interpersonally, environmentally, and socially, participants were able to provide (a) specific information to increase the understanding of compliance from their perspective and (b) recommendations for health care professionals to facilitate adherence to aftercare treatment plans.