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CARE Series: Bipolar Disorder Co-Occurring with Substance Use Disorders

  • Overview
  • Register
  • Faculty
  • Content/Tests


Date & Location
Thursday, October 29, 2026, 12:00 PM - Monday, October 29, 2029, 1:00 PM

Credits
AMA PRA Category 1 Credits™ (1.00 hours), ANCC Nursing Contact Hours (1.00 hours), CME-Designated Participation Credit (1.00 hours)

Overview

Review of:

  • Identification of bipolar disorder in patients with substance use disorders, including how to distinguish it from substance-induced mood states

  • When and how to manage bipolar disorder in general medical settings, including roles for prescribers, nursing, psychotherapy, and care coordinators

  • Management of bipolar disorder in patients actively using stimulants, opioids, or alcohol, including interactions with medications for opioid use disorder

Presenter

Jungjin Kim, MD
Medical Director, Alcohol, Drug, and Addiction Inpatient Program, McLean Hospital
Instructor in Psychiatry, Harvard Medical School


Learning Objectives
At the conclusion of this learning activity, participants will be able to:

  1. distinguish bipolar disorder from substance-induced mood presentations and substance intoxication or withdrawal.
  2. identify bipolar disorder accurately using longitudinal history and screening.
  3. initiate pharmacologic treatment safely in a general medical setting, including interactions with medications for Opioid Use Disorder.

Accreditation

In support of improving patient care, Dartmouth Health is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 

American Medical Association (AMA)
Dartmouth Health designates this Enduring Material for a maximum of 1.00 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

American Nurses Credentialing Center (ANCC)
Dartmouth Health designates this Enduring Material for a maximum of 1.00 ANCC contact hours. 

All other learners may claim CME-designated participation credit. Consult your professional licensing board regarding the applicability and acceptance of CME-designated participation credit for programs certified for credit by organizations accredited by Joint Accreditation for Interprofessional Education.


Registration/Requirements for Successful Completion

You may claim credit for successful completion of this online course. In order to claim credit, you must follow these steps:

  1. Click the Register tab above. If you are not logged into your account, you will need to log in. Use the Forgot Your Password? button if you need to reset your password.

  2. Register for the activity.

  3. Click the Content/Tests tab and then View Content to view the recording. View the entire presentation.

  4. Complete the Post-Test (attestation - return to the Content/Tests tab to find it).

  5. Click the Complete Evaluation button, or click My Account in the menu bar; then click Evaluations.

  6. Complete and Submit the Evaluation.


Bibliographic Material

  • Bartoli F, Cavaleri D, Bassetti C, Broccia M, Crocamo C, Malhi GS, and Carr G (2025). Adolescent cannabis use and onset of bipolar disorder: gaining causal clarity by viewing the evidence through the Bradford Hill lens. CNS Spectrums, 30(1), e49, 1 5.

    https://doi.org/10.1017/S1092852925100345

  • Bauer MS, McBride L, Williford WO, Glick H, Kinosian B, Altshuler L, Beresford T, Kilbourne AM, Sajatovic M; Cooperative Studies Program 430 Study Team. Collaborative care for bipolar disorder: Part II. Impact on clinical outcome, function, and costs. Psychiatr Serv. 2006 Jul;57(7):937-45. https://doi.org/10.1176/ps.2006.57.7.937. PMID: 16816277.

  • Cerimele JM, Blanchard BE, Johnson M, Russo J, Bauer AM, Veith RC, Un tzer J, Fortney JC. Effectiveness of Collaborative Care and Colocated Specialty Care for Bipolar Disorder in Primary Care: A Secondary Analysis of a Randomized Clinical Trial. J Acad Consult Liaison Psychiatry. 2023 Jul-Aug;64(4):349-356. https://doi.org/10.1016/j.jaclp.2023.02.002. Epub 2023 Feb 9. PMID: 36764483; PMCID: PMC10688610.

  • Colom F, Vieta E, Martinez-Aran A, Reinares M, Goikolea JM, Benabarre A, Torrent C, Comes M, Corbella B, Parramon G, Corominas J. A randomized trial on the efficacy of group psychoeducation in the prophylaxis of recurrences in bipolar patients whose disease is in remission. Arch Gen Psychiatry. 2003 Apr;60(4):402-7. https://doi.org/10.1001/archpsyc.60.4.402. PMID: 12695318.

  • Deng EK, Huang C, Yan VKC, Lee KJ, Leung SM, Ng VWS, Castle DJ, Chan SKW, Lai FTT, Nierenberg AA, Wei Y, Chan EW. Comparison of Long-Acting Injectable and Oral Antipsychotics in Bipolar Disorder. Am J Psychiatry. 2026 Sep 9:appiajp20250793. https://doi.org/10.1176/appi.ajp.20250793. Epub ahead of print. PMID: 42711749.

  • Frank E, Kupfer DJ, Thase ME, Mallinger AG, Swartz HA, Fagiolini AM, Grochocinski V, Houck P, Scott J, Thompson W, Monk T. Two-year outcomes for interpersonal and social rhythm therapy in individuals with bipolar I disorder. Arch Gen Psychiatry. 2005 Sep;62(9):996-1004. https://doi.org/10.1001/archpsyc.62.9.996. PMID: 16143731.

  • Ghaemi SN, Dalley S, Catania C, Barroilhet S. Bipolar or borderline: a clinical overview. Acta Psychiatr Scand. 2014 Aug;130(2):99-108. https://doi.org/10.1111/acps.12257. Epub 2014 Feb 26. PMID: 24571137.

  • Gunderson JG, Lyons-Ruth K. BPD's interpersonal hypersensitivity phenotype: a gene-environment-developmental model. J Pers Disord. 2008 Feb;22(1):22-41. https://doi.org/10.1521/pedi.2008.22.1.22. PMID: 18312121; PMCID: PMC2596628.

  • Hirschfeld RM, Calabrese JR, Weissman MM, Reed M, Davies MA, Frye MA, Keck PE Jr, Lewis L, McElroy SL, McNulty JP, Wagner KD. Screening for bipolar disorder in the community. J Clin Psychiatry. 2003 Jan;64(1):53-9. https://doi.org/10.4088/jcp.v64n0111. PMID: 12590624.

  • Hunt GE, Malhi GS, Cleary M, Lai HM, Sitharthan T. Prevalence of comorbid bipolar and substance use disorders in clinical settings, 1990-2015: Systematic review and meta-analysis. J Affect Disord. 2016 Dec;206:331-349. https://doi.org/10.1016/j.jad.2016.07.011. Epub 2016 Jul 9. PMID: 27476137.

  • Jackson A, Cavanagh J, Scott J. A systematic review of manic and depressive prodromes. J Affect Disord. 2003 May;74(3):209-17. https://doi.org/10.1016/s0165-0327(02)00266-5. PMID: 12738039.

  • Judd LL, Schettler PJ, Akiskal HS, Maser J, Coryell W, Solomon D, Endicott J, Keller M. Long-term symptomatic status of bipolar I vs. bipolar II disorders. Int J Neuropsychopharmacol. 2003 Jun;6(2):127-37. https://doi.org/10.1017/S1461145703003341. PMID: 12890306.

  • Kern JS, Cerimele JM. Collaborative Care for Patients With a Bipolar Disorder: A Primary Care FQHC-CMHC Partnership. Psychiatr Serv. 2019 Apr 1;70(4):353. https://doi.org/10.1176/appi.ps.201900019. PMID: 30929615.

  • Kilbourne AM, Goodrich DE, Lai Z, Clogston J, Waxmonsky J, Bauer MS. Life Goals Collaborative Care for patients with bipolar disorder and cardiovascular disease risk. Psychiatr Serv. 2012 Dec;63(12):1234-8. https://doi.org/10.1176/appi.ps.201100528. PMID: 23203358; PMCID: PMC4132840.

  • McCance-Katz EF, Sullivan LE, Nallani S. Drug interactions of clinical importance among the opioids, methadone and buprenorphine, and other frequently prescribed medications: a review. Am J Addict. 2010 Jan-Feb;19(1):4-16. https://doi.org/10.1111/j.1521-0391.2009.00005.x. PMID: 20132117; PMCID: PMC3334287.

  • Murray G, Harvey A. Circadian rhythms and sleep in bipolar disorder. Bipolar Disord. 2010 Aug;12(5):459-72. https://doi.org/10.1111/j.1399-5618.2010.00843.x. PMID: 20712747.

  • Pacchiarotti I, Bond DJ, Baldessarini RJ, Nolen WA, Grunze H, Licht RW, Post RM, Berk M, Goodwin GM, Sachs GS, Tondo L, Findling RL, Youngstrom EA, Tohen M, Undurraga J, Gonz lez-Pinto A, Goldberg JF, Yildiz A, Altshuler LL, Calabrese JR, Mitchell PB, Thase ME, Koukopoulos A, Colom F, Frye MA, Malhi GS, Fountoulakis KN, V zquez G, Perlis RH, Ketter TA, Cassidy F, Akiskal H, Azorin JM, Valent M, Mazzei DH, Lafer B, Kato T, Mazzarini L, Mart nez-Aran A, Parker G, Souery D, Ozerdem A, McElroy SL, Girardi P, Bauer M, Yatham LN, Zarate CA, Nierenberg AA, Birmaher B, Kanba S, El-Mallakh RS, Serretti A, Rihmer Z, Young AH, Kotzalidis GD, MacQueen GM, Bowden CL, Ghaemi SN, Lopez-Jaramillo C, Rybakowski J, Ha K, Perugi G, Kasper S, Amsterdam JD, Hirschfeld RM, Kapczinski F, Vieta E. The International Society for Bipolar Disorders (ISBD) task force report on antidepressant use in bipolar disorders. Am J Psychiatry. 2013 Nov;170(11):1249-62. https://doi.org/10.1176/appi.ajp.2013.13020185. PMID: 24030475; PMCID: PMC4091043.

  • Pallaskorpi S, Suominen K, Ketokivi M, Valtonen H, Arvilommi P, Mantere O, Lepp m ki S, Isomets E. Incidence and predictors of suicide attempts in bipolar I and II disorders: A 5-year follow-up study. Bipolar Disord. 2017 Feb;19(1):13-22. https://doi.org/10.1111/bdi.12464. Epub 2017 Feb 8. PMID: 28176421.

  • Patel R, Shetty H, Jackson R, Broadbent M, Stewart R, et al. (2015) Delays before Diagnosis and Initiation of Treatment in Patients Presenting to Mental Health Services with Bipolar Disorder. PLOS ONE 10(5): e0126530. https://doi.org/10.1371/journal.pone.0126530

  • Starzer MSK, Nordentoft M, Hjorth j C. Rates and Predictors of Conversion to Schizophrenia or Bipolar Disorder Following Substance-Induced Psychosis. Am J Psychiatry. 2018 Apr 1;175(4):343-350. doi: 10.1176/appi.ajp.2017.17020223. Epub 2017 Nov 28. Erratum in: Am J Psychiatry. 2019 Apr 1;176(4):324. https://doi.org/10.1176/appi.ajp.2019.1764correction2. PMID: 29179576.

  • Tondo L, Miola A, Pinna M, Contu M, Baldessarini RJ. Antidepressant-associated diagnostic change from major depressive to bipolar disorder. Acta Psychiatr Scand. 2024 Sep;150(3):126-137. https://doi.org/10.1111/acps.13721. Epub 2024 Jun 24. PMID: 38922810.

  • Uehlinger C, Crettol S, Chassot P, Brocard M, Koeb L, Brawand-Amey M, Eap CB. Increased (R)-methadone plasma concentrations by quetiapine in cytochrome P450s and ABCB1 genotyped patients. J Clin Psychopharmacol. 2007 Jun;27(3):273-8. https://doi.org/10.1097/JCP.0b013e3180592ad2. PMID: 17502774.

  • Vermont Department of Health, Annual Suicide Data Report, June 2026 https://www.healthvermont.gov/stats/data-reporting-topic/suicide-data

  • Weiss RD & Connery HS. Integrated Group Therapy for Bipolar Disorder and Substance Abuse. Guilford, 2011

  • Weiss RD, Griffin ML, Jaffee WB, Bender RE, Graff FS, Gallop RJ, Fitzmaurice GM. A "community-friendly" version of integrated group therapy for patients with bipolar disorder and substance dependence: a randomized controlled trial. Drug Alcohol Depend. 2009 Oct 1;104(3):212-9. https://doi.org/10.1016/j.drugalcdep.2009.04.018. Epub 2009 Jul 1. PMID: 19573999; PMCID: PMC2735139.

  • Yatham LN, Kennedy SH, Parikh SV, Schaffer A, Bond DJ, Frey BN, Sharma V, Goldstein BI, Rej S, Beaulieu S, Alda M, MacQueen G, Milev RV, Ravindran A, O'Donovan C, McIntosh D, Lam RW, Vazquez G, Kapczinski F, McIntyre RS, Kozicky J, Kanba S, Lafer B, Suppes T, Calabrese JR, Vieta E, Malhi G, Post RM, Berk M. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. Bipolar Disord. 2018 Mar;20(2):97-170. https://doi.org/10.1111/bdi.12609. Epub 2018 Mar 14. PMID: 29536616; PMCID: PMC5947163.

  • Yildiz A, Siafis S, Mavridis D, Vieta E, Leucht S. Comparative efficacy and tolerability of pharmacological interventions for acute bipolar depression in adults: a systematic review and network meta-analysis. Lancet Psychiatry. 2023 Sep;10(9):693-705. https://doi.org/10.1016/S2215-0366(23)00199-2. PMID: 37595997.

Provider Contact Information
Provider contact information for questions regarding accreditation of the activity:

Center for Learning and Professional Development
ACE Office
Dartmouth Health
[email protected]

Mitigation of Relevant Financial Relationships

Dartmouth Health adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education.  Any individuals in a position to control the content of a CE activity, including planners, faculty, authors, or others are required to disclose all financial relationships with ineligible companies^.  All relevant financial relationships have been mitigated prior to the commencement of the activity.

^Ineligible Company is any entity whose primary business purpose is producing, marketing, selling, re-selling or distributing healthcare products used by or on patients.

Member Information
Role in activity
Nature of Relationship(s) / Name of Ineligible Company(s)
Owen Murray, MS, LMFT
Project Manager
Dartmouth College
Course Director
Nothing to disclose
Jungjin Kim, MD
McLean
Faculty
Nothing to disclose
Steven H Chapman, MD
Physician
Dartmouth Hitchcock Medical Center
Other Planning Committee Member
Nothing to disclose
Daisy J Goodman, DNP, Associate Professor of OB/GYN
Nurse Midwife
Dartmouth Hitchcock Medical Center
Other Planning Committee Member
Nothing to disclose
Bethany McLeman, BA
Research Project Director
Dartmouth College
Other Planning Committee Member
Nothing to disclose

CARE Series: Bipolar Disorder Co-Occurring with Substance Use Disorders
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