Comorbid substance use disorder in women with bipolar disorder associated with criminal arrest

Objectives: Previous research has indicated that comorbid substance abuse in patients with bipolar disorder (BPD) is strongly linked to criminal arrest. This study was conducted to further evaluate possible gender differences in substance use and risk of criminality in BPD. Methods: Subjects were selected from all inmates with a DSM-IV diagnosis of BPD type I at Los Angeles County correctional facility. As a comparison, a sample of Los Angeles County patients with BPD type I who had not been arrested during the course of their psychiatric treatment within LA County was identified. The county's Management Information System (MIS) was utilized to obtain primary and secondary diagnoses as well as demographic information. Results: The odds of having a comorbid substance use diagnosis for arrested female patients was more than 38 times that for community female patients (odds ratio=38.75). Women were more likely to have been arrested for violent and substance use charges; men were more likely to have been arrested for theft and miscellaneous charges. Conclusions: Substance abuse appears to be a significant risk factor for arrest in patients with BPD and is especially significant for women with BPD. Our study suggests that comorbid BPD and substance use in women may significantly increase the risk of criminal arrest.