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Commentary: Substance Abuse and Criminality in the Mentally Disordered Defendant

Dr. Easton is Assistant Professor of Psychiatry, Yale University School of Medicine, and Director of Drug Diversion and of Substance Abuse & Domestic Violence Services, Connecticut Mental Health Center, New Haven, CT. Address correspondence to: Caroline Easton, PhD, Yale University School of Medicine, SATU/ASAP, Box 18, 1 Long Wharf, New Haven, CT 06511. E-mail: caroline.easton{at}yale.edu

This commentary discusses the main findings of the research study by Friedman et al. entitled, "Gender Differences in Criminality: Bipolar Disorder with Co-occurring Substance Abuse." Moreover, it shows that the role of substance use should be determined in studies that assess outcomes among co-occurring disorders, such as bipolar disorder and criminal behavior. High rates of substance-related problems were recorded in the study by Friedman et al. Fifty-six percent of the patients with dual-diagnosis, rapid-cycling bipolar disorder had been charged with drug- or alcohol-related offenses. Significantly more men (69%) had incurred substance-related charges than had women (38%). Women who abused cocaine were more likely to be charged with a crime than were those who had not. Sixty-five percent of the women in the study who abused cocaine had been previously charged with a crime, compared with 38 percent of the women who did not; but this finding did not hold true for the men. The number of crimes committed by the men who abused cocaine and by those who did not was about the same. This article also provides an overview of the role of substance use in criminal behavior and how substances of abuse can affect bipolar disorder and criminal outcomes.