Reply to Self-Medication, Bipolar Disorders, and Stimulant Dependence
J Clin Psychiatry 2009;70(6):936-937 [reply letter]
© Copyright 2015 Physicians Postgraduate Press, Inc.
Purchase This PDF for $40.00
If you are not a paid subscriber, you may purchase the PDF.
(You'll need the free Adobe Acrobat Reader.)
Receive immediate full-text access to JCP. You can subscribe to JCP online-only ($86) or print + online ($156 individual).
With your subscription, receive a free PDF collection of the NCDEU Festschrift articles. Hurry! This offer ends December 31, 2011.
If you are a paid subscriber to JCP and do not yet have a username and password, activate your subscription now.
As a paid subscriber who has activated your subscription, you have access to the HTML and PDF versions of this item.
Click here to login.
Did you forget your password?
Still can't log in? Contact the Circulation Department at 1-800-489-1001 x4 or send email
Letter to the Editor
Sir: We appreciate the opportunity to reply to the insightful
comments of Drs. Khantzian and Albanese regarding the selfmedication
hypothesis and our recent findings published in August
2008. We acknowledge that addiction etiology includes a
domain of psychologically distressing subjective factors such as
problems regulating self-esteem, relationships, and self-care, as
stated by Khantzian and Albanese.
Nejtek et al. used DSM-IV criteria for all subjects. Substance
“dependence” includes persistent psychological problems
and impaired social, occupational, and/or interpersonal functioning.
DSM-IV criteria for bipolar disorder suggest a level of severity
causing “marked impairment” evident in depressive and
manic symptoms such as psychomotor agitation, sleep disturbances,
excessive positive or negative self-worth, or irritability
creating an “unequivocal and uncharacteristic change in functioning
that is observed by others.”