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Evaluation of an integrated risk reduction intervention's effects on substance use spectrum measures in patients with bipolar I disorder

Bixler, Felicia (2015) Evaluation of an integrated risk reduction intervention's effects on substance use spectrum measures in patients with bipolar I disorder. Master's Thesis, University of Pittsburgh. (Unpublished)

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Background: Substance use is common among people with bipolar I disorder, a mental illness marked by periods of mania and depression. Although substance use affects people with bipolar I disorder more than the general population, and psychotherapy-inclusive treatments show promise in treating comorbid substance use and bipolar I disorders, no studies to our knowledge have applied these treatments to bipolar I disorder people with sub-threshold substance use. The public health importance of minimizing substance use in people with bipolar I disorder is to minimize impacts such as hospitalization costs, lost compensation, and early mortality, through control of symptoms.
We conducted secondary analyses to determine whether one such treatment, integrated risk reduction intervention (IRRI), decreased substance use spectrum measures more than standard care, psychiatric care with medical monitoring (PCMM). The primary study was a randomized controlled trial conducted to reduce medical risks and minimize morbidity and mortality in bipolar I disorder participants. In our current secondary analyses, we hypothesized that 1) all participants would have decreased substance use spectrum measures after 6 months of either treatment, 2) IRRI participants would have a greater decrease than PCMM participants,and 3) the change in substance use spectrum measures would decrease more among those with a prior alcohol use disorder than those with no prior alcohol use disorder.
Methods: Participants were recruited in Pittsburgh, PA and randomly assigned to IRRI (n=58) or PCMM (n=56). Four substance use spectrum measures from the Self-Report Last Month Substance Use Spectrum assessment (SUBS-SR – Last Month) were evaluated, if completed at both study entry and 6 months. Wilcoxon signed rank tests, Wilcoxon rank sum tests, and multiple linear regression were used for analyses.
Results: There were no significant changes in substance use spectrum measures from study entry to 6 months among all participants. There were no clinically meaningful differences in substance use measures between IRRI and PCMM participants or between participants with versus without a lifetime alcohol use disorder.
Conclusions: The current format of IRRI does not appear to have an effect on substance use spectrum measures after 6 months of treatment. The public health implications of this study are that further study is needed to identify the effectiveness of psychotherapy-related treatment of sub-threshold substance use in bipolar I disorder patients.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Bixler, Feliciafrb19@pitt.eduFRB19
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairRichardson, Galegar@pitt.eduGAR
Committee MemberFrank,
Committee MemberBrooks, Mariabrooks@edc.pitt.eduMBROOKS
Committee MemberGlynn, Nancyglynnn@edc.pitt.eduEPIDNWG
Date: 28 September 2015
Date Type: Publication
Defense Date: 22 April 2015
Approval Date: 28 September 2015
Submission Date: 6 April 2015
Access Restriction: 2 year -- Restrict access to University of Pittsburgh for a period of 2 years.
Number of Pages: 60
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: MS - Master of Science
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: bipolar disorder, bipolar I disorder, substance use, integrated intervention
Date Deposited: 28 Sep 2015 17:58
Last Modified: 01 Sep 2017 05:15


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