The effects of comorbid psychiatric disorders on treatment-seeking for SUD was substantially smaller than previously reported corresponding effects on treatment-seeking for mood (Moreno et al., 2012; Olfson et al., 2012) or anxiety disorders (Iza et al., 2013). The smaller effects on treatment-seeking for SUD are consistent with a predominance of external factors, rather than internal motivation on treatment-seeking for SUD. In the multivariable models, bipolar disorder increased the likelihood of treatment-seeking for alcohol abuse and dependence, but not for drug abuse or dependence. The reason for these associations may be related to the differences in the pharmacological effects of alcohol and drugs or their effects on bipolar symptoms. It is also possible that alcohol abuse and dependence are perceived as more severe in the presence of mood swings, whereas comorbidity of bipolar disorder does not increase the perceived severity of drug abuse and dependence. Furthermore, individuals with bipolar and alcohol use disorders, which commonly co-occur (Blanco et al., 2002; Hasin et al., 2007; Oquendo et al., 2010), may enter the treatment system through the treatment of bipolar disorder and then
