Current Substance Use Tripled Violence Risk in Male Bipolar Patients
Among 100 hospitalized male bipolar patients, current substance use was associated with a threefold increase in violent behavior, with cannabis, alcohol, and synthetic cannabinoids as the most commonly used substances.
Quick Facts
What This Study Found
Researchers evaluated 100 male inpatients with bipolar disorder type I during mood episodes to identify factors associated with violent behavior (defined as physical aggression against others).
Current substance use, rather than lifetime history of substance use disorder, was the key predictor: it was associated with a threefold increase in violence risk. The lifetime rate of substance use disorder in this population was 59%, and 39% were currently using substances.
Cannabis and alcohol were the most commonly used substances in both lifetime and current use groups, followed by synthetic cannabinoids. Patients who used any substance were more likely to have criminal records and prior incarceration. A previous history of violent behavior was another significant risk factor.
Key Numbers
100 male inpatients studied. 59% had lifetime substance use disorder. 39% had current substance use. Current use associated with 3x increased violence risk. Cannabis and alcohol were the most commonly used substances.
How They Did This
One hundred male inpatients diagnosed with bipolar disorder type I were assessed during a current mood episode using validated scales including the Young Mania Rating Scale, Hamilton Depression Rating Scale, Barratt Impulsivity Scale, and Overt Aggression Scale. Logistic regression was used to predict violent behavior.
Why This Research Matters
Understanding that current substance use, not just lifetime history, drives violence risk in bipolar disorder has practical implications for clinical management. It suggests that addressing active substance use could reduce violent behavior in this population.
The Bigger Picture
The co-occurrence of substance use and bipolar disorder is common and complicates treatment. This study adds to evidence that active substance use, particularly cannabis and alcohol, is associated with worse behavioral outcomes during mood episodes.
What This Study Doesn't Tell Us
The sample was limited to male inpatients, so findings may not apply to female patients or outpatients. Self-reported substance use may be inaccurate. Synthetic cannabinoid use relied on patient and family reports due to lack of laboratory detection. The cross-sectional design cannot establish causation.
Questions This Raises
- ?Would treating active substance use in bipolar patients reduce violent incidents?
- ?Do different substances carry different levels of violence risk in bipolar disorder?
Trust & Context
- Key Stat:
- Current substance use associated with 3x increase in violent behavior
- Evidence Grade:
- This is a small cross-sectional study of 100 male inpatients at a single center. The findings are preliminary and cannot establish causation.
- Study Age:
- Published in 2016. Research on the bipolar-substance use relationship has continued to develop.
- Original Title:
- Substance use is a risk factor for violent behavior in male patients with bipolar disorder.
- Published In:
- Journal of affective disorders, 193, 89-93 (2016)
- Authors:
- Alnıak, İzgi(2), Erkıran, Murat(3), Mutlu, Elif
- Database ID:
- RTHC-01089
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Does cannabis cause violence in bipolar patients?
The study found an association between current substance use (including cannabis) and violent behavior, but cannot prove causation. The relationship is likely complex, involving impulsivity, mood state, and other factors alongside substance use.
Why was current use more important than lifetime history?
The findings suggest that active intoxication or recent substance effects, rather than a distant history of use, are what increase violence risk during bipolar mood episodes. This makes clinical sense, as active substances directly affect brain function and impulse control.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-01089APA
Alnıak, İzgi; Erkıran, Murat; Mutlu, Elif. (2016). Substance use is a risk factor for violent behavior in male patients with bipolar disorder.. Journal of affective disorders, 193, 89-93. https://doi.org/10.1016/j.jad.2015.12.059
MLA
Alnıak, İzgi, et al. "Substance use is a risk factor for violent behavior in male patients with bipolar disorder.." Journal of affective disorders, 2016. https://doi.org/10.1016/j.jad.2015.12.059
RethinkTHC
RethinkTHC Research Database. "Substance use is a risk factor for violent behavior in male ..." RTHC-01089. Retrieved from https://rethinkthc.com/research/aln-ak-2016-substance-use-is-a
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.