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001), suicide attempts (p=0.002), aggression (p=0.003), antidepressant-induced manic switch (p=0.003), and poor treatment response (p0.001) were more frequent in the SUD-BD subgroup. At the logistic regression, SUD revealed a positive association with BD type I diagnosis (Odds Ratio (OR) 4.77, 95% CI 1.66-13.71, p=0.004) and mixed features (OR 2.54, 95% CI 1.17-5.53, p=0.019). The cross-sectional study design and the relatively small sample size may limit the generalizability of the findings. The retrospective evaluation of comorbid