Bipolar disorder preceded by substance abuse: a different phenotype with not so poor outcome?

Background: The co-occurrence of bipolar disorder and substance use is frequent. The question whether substance use precedes, induces or follows bipolar disorder is still unresolved. Substance use has been typically represented as a negative prognostic factor for the clinical course of bipolar illness and it has been associated with decreased compliance and treatment resistance.

A randomized trial on the efficacy of group psychoeducation in the prophylaxis of recurrences in bipolar patients whose disease is in remission.

Background: Studies on individual psychotherapy indicate that some interventions may reduce the number of recurrences in bipolar patients. However, there has been a lack of structured, well-designed, blinded, controlled studies demonstrating the efficacy of group psychoeducation to prevent recurrences in patients with bipolar I and II disorder.

Methods: One hundred twenty bipolar I and II outpatients in remission (Young Mania Rating Scale score <6, Hamilton Depression Rating Scale-17 score <8) for at least 6 months prior to inclusion in the study, who were receiving standard pharmacologic treatment, were included in a controlled trial.