B ipolar and substance use disorders frequently coexist. In a literature review on the subject, Brady and Lydiard 1 estimated that alcohol or drug problems occur in 21% to 58% of patients with bipolar disorder. More recently, Keck and colleagues 2 found that of 106 bipolar patients who were followed for 12 months after hospitalization for either a manic or a mixed mood episode, 55% met criteria for a substance use disorder. Comorbidity between these two disorders is associated with a worse prognosis than with either diagnosis alone, including slower recovery time 3 and more psychiatric hospitaliza- tions. 4 REGULAR ARTICLES Utilization of Psychosocial Treatments by Patients Diagnosed with Bipolar Disorder and Substance Dependence Roger D. Weiss, M.D., Monika E. Kolodziej, Ph.D., Lisa M. Najavits, Ph.D., Shelly F. Greenüeld, M.D., M.P.H., Lisa M. Fucito, B.A. We investigated psychosocial treatment interventions, mood symptoms, and substance use among 24 patients with bipolar disorder and substance dependence. Patients were assessed for 6 months following hospital dis- charge. Psychotherapy and Alcoholics Anonymous (AA) attendance decreased over time. Moreover, the focus of patients’ psychotherapy changed over time, with decreasing emphasis on the patients’ speci®c disorders. Mood symptoms and substance use did not change signi®cantly over time, although there was a trend toward more frequent drug use over time. These ®ndings point to infrequent utilization over time of psychosocial treatments focusing speci®cally on bipolar and substance use disorder. (Am J Addict 2000;9:314–320) 314 Received July 26, 1999; revised October 29, 1999; accepted December 13, 1999. From the Alcohol and Drug Abuse Treatment Program, McLean Hospital, Belmont, Mass.; and the Depart- ment of Psychiatry, Harvard Medical School, Boston, Mass. (Drs. Weiss, Kolodziej, Najavits, and Green®eld). Address correspondence to Dr. Weiss, McLean Hospital, 115 Mill St., Belmont, MA 02478. E-mail: weissr mcleanpo.mclean.org. The American Journal on Addictions 9:314–320, 2000 Published by Brunner/Mazel # 2000 American Academy of Addiction Psychiatry 1055-0496/00 $12.00 + .00