Substance use disorders (SUD) have been frequently linked with SUD in offspring and bipolar disorder leading to a variety of consequences. Bipolar disorder (BPD) and substance dependence are chronically relapsing disorders with heterogeneous presentations and increasingly variable natural histories. Similar to SUDs, BPD often goes undiagnosed and untreated for many years and later coming to clinical attention after significant progression of the disease. The study of the relationship between substance use disorders and bipolar disorder is important in mental nursing because it reveals the meaningful disparities of individuals with SUD and BPD in terms of demographic characteristics, psychiatric comorbidity, risk factors, and clinical correlates. Previous research has shown that adolescents with BPD are at an inclined risk for developing SUD. Therefore, examining the parental history SUD on the risk of offspring substance abuse with and without BPD is important in assisting medical practitioners educate and monitor families at increased risk. In particular, clarifying mechanisms linking adolescents SUD and parents would also facilitate constructive approaches to lessen threats related with maternal drug abuse. Therefore, this paper reviews literature and findings on the relationship of family history of SUD and BPD that is based on of bipolar disease using a controlled case study.
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Scholars have documented studies of parents and have established a significant correlation between BPD and SUD. Most recently, statistical data has shown that primary inception of bipolar disease is associated to increased risk of SUD. High rates of BPD and SUD have been frequently reported in community and clinical samples and have also been shown to be in relation to worse health outcome, greater severity of psychiatric illness, and increased number of hospitalizations (Tarter, Vanyukov & Center for Education and Drug Abuse Research, 2001). A long-term follow-up investigation established that comorbid substance abuse disorder among BPD persons increased the recurrence of the disorder. Therefore, BPD and SUD represent clinical challenges that have made management more complex. The associated symptoms of BPD include fatigue, irritability, and lack of concentration, sleep disorders, and muscle tension among others. Both BPD and SUD are chronic and disabling conditions that are associated with high rates of psychiatric comorbidity and significant societal, personal, and economic expenses. Meanwhile, the increased prevalence of SUDs in BPD patients shows that approximately 60 % of patients suffering from BPD often suffer subsequent development of SUD at a particular stage in life. Moreover, conditions resulting from use of alcohol are prevalent among patients with bipolar and has an occurrence of 50% in approximation (Tolliver, 2010).
In a study that studied 190 patients established through 104 youths with BPD and 189 patients established through 98 controlled studies using structured interviews, Wilens, Yule, Martelon, et al. (2014) provided significant results for mental nursing literature. According to the results, subjects that had a SUD maternal history were found to be expected to abuse drug (alcohol) in comparison to their counterparts lacking a maternal history. Moreover, the participants of the research that had a SUD parent history were at an inclined position of having drug abuse disorder, unlike their peers lacking SUD from their parents. Therefore, Wilens et al. (2014) concluded that drug use conditions were more prevalent in adolescents whose paternities had history of SUD likened to parents deprived of SUD, yet the threat was never prejudiced by bipolar disease.
The information documented in the article on the history of parental-offspring SUD and BPD would have important implication in mental nursing. Indeed, an improved comprehension of family history as a risk factor for substance abuse disorder have clinical and public health inferences. The article adds to the BPD developing SUD literature with robust scientific significance to clinicians. The information presented in the article can help improve my practice in mental nursing. Particularly, it would help facilitate risk mitigation strategies about familial histories of substance abuse for vulnerable communities. Also, it is useful in increasing my knowledge of the topic and would help me enlighten families at high risk of developing SUD as well as sharing information with colleagues at work. This would create a good working relationship at work and also help reduce chances of parental-offspring related substance abuse disorders. Overall, the information in the article is important in providing family-focused therapy, psycho-education, and interpersonal therapy to families.
The use of large samples that represent the salient characteristics of the population in conducting the research is one of the strongholds of satisfying the results. The use of a big sample reduces chances of error in research, hence hinting the strength of the article. However, one weakness is the use of Caucasian and ascertained samples from advertisements and outpatient referrals, as such, it may be inaccurate because it may not generalize the minority in the samples. Also, the researchers used subjects with an average age of 13 years. This population may not show the full risk of SUD considering their young ages. Therefore, the results from the research would have underrepresented the full risk of SUD as may be seen in full grown adolescents. Lastly, the use of interview method in data collection, as opposed to experiments, might not have captured important aspects of SUD, including urine toxicology that would have provided more accurate data.
Despite the methodological challenges, the data provided in the reviewed article is very important in improving nursing practice in mental patients. Therefore, it would be reasonable to recommend the article for colleagues in the mental nursing field for the improvement of practice, particularly in providing cognitive behavioral therapy, psychological education, and family-focused therapy.
Mental nursing is an important facet in the healthcare sector and the community at large. Therefore, studying the relationship between substance use disorders and bipolar disease about family histories is important in improving knowledge required for clinical interventions. Alcohol use disorders are common among adolescents whose parents’ reports histories of SUD, and this would mental nurses provide family education and monitoring programs.
Tarter, R. E., Vanyukov, M. M., & Center for Education and Drug Abuse Research. (2001). Etiology of substance use disorder in children and adolescents: Emerging findings from the Center for Education and Drug Abuse Research. New York: Haworth Press.
Tolliver, B. (2010). Bipolar disorder and substance abuse: Overcome the challenges of ‘dual diagnosis’ patients. Evidence-Based Reviews. Vol. 9, No. 8 / August 2010
Wilens, T. E., Yule, A., Martelon, M., Zulauf, C., & Faraone, S. V. (January 01, 2014). Parental history of substance use disorders (SUD) and SUD in offspring: a controlled family study of bipolar disorder. The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions, 23, 5.)
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