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Differences in prevalence and patterns of substance use in schizophrenia and bipolar disorder

Published online by Cambridge University Press:  10 December 2007

P. A. Ringen*
Institute of Psychiatry, Medical Faculty, University of Oslo, Oslo, Norway
T. V. Lagerberg
Institute of Psychiatry, Medical Faculty, University of Oslo, Oslo, Norway
A. B. Birkenæs
Division of Psychiatry, Ullevål University Hospital, Oslo, Norway
J. Engn
Division of Psychiatry, Ullevål University Hospital, Oslo, Norway
A. Færden
Division of Psychiatry, Ullevål University Hospital, Oslo, Norway
H. Jónsdottir
Division of Psychiatry, Ullevål University Hospital, Oslo, Norway
R. Nesvåg
Department of Psychiatry, Diakonhjemmet Hospital, Oslo, Norway
S. Friis
Division of Psychiatry, Ullevål University Hospital, Oslo, Norway
S. Opjordsmoen
Division of Psychiatry, Ullevål University Hospital, Oslo, Norway
F. Larsen
Division of Psychiatry, Ullevål University Hospital, Oslo, Norway
I. Melle
Institute of Psychiatry, Medical Faculty, University of Oslo, Oslo, Norway
O. A. Andreassen
Division of Psychiatry, Ullevål University Hospital, Oslo, Norway
*Address for correspondence: Dr P. A. Ringen, Department of Education and Research, Division of Psychiatry, Building 49, Ullevål University Hospital, N-0407Oslo, Norway. (Email:



Schizophrenia and bipolar disorder have partly overlapping clinical profiles, which include an over-representation of substance-use behaviour. There are few previous studies directly comparing substance-use patterns in the two disorders. The objective of the present study was to compare the prevalence of substance use in schizophrenia and bipolar disorder, and investigate possible differences in pattern and frequency of use.


A total of 336 patients with schizophrenia or bipolar spectrum disorder from a catchment area-based hospital service were included in a cross-sectional study. In addition to thorough clinical assessments, patients were interviewed about drug-use history, habits and patterns of use. The prevalence and drug-use patterns were compared between groups.


Patients with bipolar disorder had higher rates of alcohol consumption, while schizophrenia patients more often used centrally stimulating substances, had more frequent use of non-alcoholic drugs and more often used more than one non-alcoholic drug. Single use of cannabis was more frequent in bipolar disorder.


The present study showed diagnosis-specific patterns of substance use in severe mental disorder. This suggests a need for more disease-specific treatment strategies, and indicates that substance use may be an important factor in studies of overlapping disease mechanisms.

Original Articles
Copyright © 2007 Cambridge University Press

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