Impact of substance use on the physical health of patients with bipolar disorder

Garcia‐Portilla MP, Saiz PA, Benabarre A, Florez G, Bascaran MT, Díaz EM, Bousoño M, Bobes J. Impact of substance use on the physical health of patients with bipolar disorder. Objective: To describe the impact of tobacco, alcohol and cannabis on metabolic profile and cardiovascular risk in bipolar patients. Method: Naturalistic, cross‐sectional, multicenter Spanish study. Current use of tobacco, alcohol and cannabis was determined based on patient self‐reports. Metabolic syndrome was defined using the National Health and Nutrition Examination Survey 1999–2000 and the American Heart Association/National Heart, Lung and Blood Institute criteria, and cardiovascular risk using the Framingham and the Systematic Coronary Risk Evaluation functions. Results: Mean age was 46.6 years, 49% were male. Substance use: 51% tobacco, 13% alcohol and 12.5% cannabis. Patients who reported consuming any substance were significantly younger and a higher proportion was male. After controlling for confounding factors, tobacco was a risk factor for coronary heart disease (CHD) (unstandardized linear regression coefficient 3.47, 95% confidence interval 1.85–5.10). Conclusion: Substance use, mainly tobacco, was common in bipolar patients. Tobacco use negatively impacted CHD risk.