The Association Between Moderate Alcohol Use and Illness Severity in Bipolar Disorder: A Preliminary Report.
J Clin Psychiatry 2006;67:102-106
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objective: To examine the association of
alcohol consumption with symptoms, illness course, and health care utilization among
non-alcoholic patients with bipolar disorder.
Method: Subjects were 148 patients with
bipolar I or II disorder enrolled in a
longitudinal study of cognitive-behavioral therapy
versus psychoeducation. Subjects were 18 to 60
years old, in full or partial remission, and
non-heavy drinkers with no history of substance use
disorders. At least 4 weeks of consistent
naturalistic treatment with mood stabilizer was required
for enrollment. Measures included the Structured Clinical Interview for DSM-IV, the Hamilton
Rating Scale for Depression, the Clinician-Administered Rating Scale for Mania, and the
Khavari Alcohol Test. Data were gathered from July
2002 to December 2004.
Results: Mean weekly alcoholic beverage
consumption was minimal among both men (3.8 standard drinks, SD = 8.9) and women (1.2
standard drinks, SD = 1.9). Nonetheless, total alcohol
consumption among men was associated with lifetime manic episodes (F = 10.2, df = 1, p = .003)
and emergency department visits (F = 4.3, df = 1, p = .046). Spirits consumption among men
was strongly associated with lifetime manic
episodes (F = 81.8, df = 1, p < .001) and emergency
department visits (F = 14.0, df = 1, p < .001). Among women, the frequency of alcohol
consumption was associated with lifetime episodes of
depression (F = 15.5, df = 1, p < .001) and hypomania (F = 4.8, df = 1, p < .03). Wine consumption
among women was associated with lifetime hypomanic episodes (F = 13.6, df = 1, p < .001) and
current manic symptoms (F = 4.0, df = 1, p < .05).
Conclusion: Despite low volumes of
consumption, alcohol was associated with measures of illness severity in bipolar disorder among
both men and women. The adverse effects of alcohol on bipolar disorder may occur over a range
of consumption, rather than being confined to