European Psychiatry - Volume 41 - April 2017

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S466 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S465–S520
EV0191
Bipolar disorder and substance use
disorders in a Tunisian sample
S. Ben Mustapha ∗, W. Homri , R. Labbane
Razi Hospital, service de psychiatrie C, Mannouba, Tunisia
∗ Corresponding author.
Aims Describe the sociodemographic and clinical profile of
patients suffering from bipolar disorder and substance use disor-
ders comorbidity and assess the consequences of this comorbidity
on prognosis and evolution of bipolar disorder,
Methods A case-control study, 100 euthymic patients treated for
bipolar disorder, recruited in the department of psychiatry C of
Razi hospital. Two groups of 50 patients were individualized by the
presence or not of substance use disorders comorbidity. The two
groups were compared for sociodemographic, clinical, therapeutic
and historical characteristics.
Results Compared to bipolar patients without addictive comor-
bidity, those with this comorbidity had the following character-
istics: we found more male, less family cohesion, more domestic
violence, more criminal records, more time spent abroad, more
personality disorders especially antisocial and borderline, fewer
triggers of bipolar illness, moremood episodes, more psychotic fea-
tures, higher impulsivity BIS-10 score, an increased need to put in
a neuroleptic long term treatment, poor adherence to treatment,
lower response to treatment, lower score of global assessment of
functioning (GAF), more rapid cycles, shorter period of remission,
longer duration of the last mood episode, poor socio-professional
integration and poor quality of intervals between mood episodes.
Conclusions It seems important to insist on the identification and
the treatment of bipolar disorder or substance use disorders when
one of them is diagnosed. This needs to set up urgently facilities
and care structures for patients with substance use disorders and
to create more addiction consultations.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0192
Bipolar disorder and co-occurring
cannabis use disorders
S. Ben Mustapha ∗, W. Homri , L. Jouini , R. Labbane
Razi Hospital, service de psychiatrie C, Mannouba, Tunisia
∗ Corresponding author.
Aims Assess the prevalence of cannabis use disorders (CUD) in
patients with bipolar disorder, describe the demographic and clini-
cal profile socio bipolar patientswith comorbid addictive and assess
the implications of this comorbidity on prognosis and evolution of
bipolar disorder.
Methods A case-control study, 100 euthymic patients treated for
bipolar disorder, recruited in the department of psychiatry C of
Razi hospital. Two groups were individualized by the presence or
not of cannabis use disorders comorbidity. The two groups were
compared for sociodemographic, clinical, therapeutic and historical
characteristics.
Results The prevalence of CUD was 27.53% (n = 19) in our sample.
Comparing bipolar patients according to the presence or absence
of CUD, we found the following results with patients with CUD
comorbidity: younger, mostly male, a disturbed family dynamic,
low educational level, poor socio-economic conditions, more time
abroad history, more suicide attempts in history, more criminal
record, more psychiatric family history, an earlier onset of the
disease, a longer duration of undiagnosed bipolar disorder, more
personality disorder, more frequent presence of a triggering factor
for bipolar disorder, more psychotic features duringmood episodes,
more need of antipsychotic long-term treatment.
Conclusions The frequency of CUD in BD is higher than the preva-
lence in the general population and CUD is a factor in the evolution
and prognosis of bipolar disorder and promotes the development
of mood disorders in predisposed patients.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0193
Comparison of insight in bipolar
disorder with and without co-morbid
substance use disorders
S. Ben Mustapha ∗, W. Homri , L. Jouini , R. Labbane
Razi Hospital, service de psychiatrie C, Mannouba, Tunisia
∗ Corresponding author.
Aims Compare the level of insight in bipolar disorder (BD) with
and without substance use disorders (SUD).
Methods Case-control study during a period of six months from
July 2015 to December 2015. One hundred euthymic patients with
BD (type I, II or unspecified) were recruited in the department of
psychiatry C Razi Hospital, during their follow-up. Two groupswere
individualized by the presence or not of eval-
uated and compared insight with Birchwood IS scale (with its three
sub-scales),
Results The mean age was 40.6 years (±16.4). The sex ratio was 2.
Sixty-six percent of patients were diagnosed with bipolar disorder
type 1 and type 2 bipolar disorder remains.
There is no statistically significant difference between bipolar with
and without SUD in terms of quality of insight.
As for the subscales, bipolar patients with comorbid SUD had lower
scores of awareness of any symptoms, whereas there was no sig-
nificant difference regarding the awareness of illness and the need
for treatment between the two populations.
Conclusions Co-morbid SUD can affect the quality of insight
in individuals with BD. Patients with this co-morbidity should
be targeted for intensive psycho-educational measures and psy-
chotherapeutic interventions focused on the improvement of
insight.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0194
Attempted suicide in people with
co-occurring bipolar and substance
use disorders
S. Ben Mustapha ∗, W. Homri , L. Jouini , R. Labbane
Razi Hospital, service de psychiatrie C, Mannouba, Tunisia
∗ Corresponding author.
Aims Study the impact of SUD co-morbidity on suicide risk in
patients with BD.
Methods Case-control study during a period of six months from
July 2015 to December 2015. One hundred euthymic patients with
BD (type I, II or unspecified) were recruited in the department of
psychiatry C Razi Hospital, during their follow-up. Two groupswere
individualized by the presence or not of a SUD co-morbidity.
Results The average age of patients with SUD was 44.02 years
that of the patients without SUD was 44.12 years.
The sex ratio of patients with SUD was 5.25 and that of patients
without SUD were 0.61.
Twenty-six percent of patients with SUD comorbidity had a history
of suicide attempts. Fourteen percent of patients without SUD had
a history of suicide attempts.
The association between SUD and history of suicide attempts was
not significant (P= 0.134).