Substance-Induced Mood Disorders

Excerpt

Although, both illicit substances and iatrogenic medications are ingested with the impetus to alleviate mood, a substantial proportion of patients experience paradoxical affective disorders following the ingestion of said substances. Instead of the prosaic euphoria experienced while intoxicated or the subsequent day 'hangover,' some individuals will become manic or enter into a state of depression. Mood disorders that precipitate only in association with substance use are specified as 'substance-induced.' Affective disorders that can precipitate in the setting of substance use include both bipolar and related disorders and depressive disorders. These disorders were previously found within the nosological category of substance-induced mood disorders, in DSM-IV. However, in the current DSM 'substance-induced' is now a specifier for mood disorders.

Depression and bipolar disorder frequently co-occur with substance use disorders (SUDs) and are prevalent in the general population. This review will reflect on both substance-induced depressive disorder and substance-induced bipolar and related disorders, and further elaborate on how they can be distinguished from mood disorders that are comorbid with SUDs.

For the purpose of this review, the designation of substance-induced mood disorders - although no longer a distinct category in DSM-V - will represent both substance-induced depression and bipolar disorders.