A Gender-Focused Perspective on Health Service Utilization in Comorbid Bipolar I Disorder and Alcohol Use Disorders: Results From the National Epidemiologic Survey on Alcohol and Related Conditions
J Clin Psychiatry 2006;67:925-932
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objectives: This study compares health
service utilization by individuals with comorbid
lifetime bipolar I disorder and lifetime alcohol use
disorders (AUD) to that of individuals with either
diagnosis alone, using nationally representative data.
Method: The 2001-2002 National
Epidemiologic Survey on Alcohol and Related Conditions was
used to identify respondents with bipolar I disorder
only (BD-only; N = 636), AUD only (N = 11,068), and comorbid bipolar I disorder and AUD
(BD-AUD; N = 775). Diagnoses were generated using the
National Institute on Alcohol Abuse and Alcoholism Alcohol Use Disorder and Associated
Disabilities Interview Schedule-DSM-IV Version. The 3
groups were compared with respect to self-reported
health service utilization.
Results: For both men and women,
respondents in the BD-AUD group were significantly more
likely than AUD-only respondents to report any
alcohol-related service utilization (p < .001). BD-AUD
respondents were significantly more likely to
report bipolar disorder-related hospital admissions as
compared with BD-only respondents among males only (p = .009). Within the BD-AUD group, males
reported significantly greater utilization of AUD
treatment only (p < .001), and females reported
significantly greater utilization of bipolar disorder treatment
only (p < .001) and significantly greater likelihood of
utilizing mental health services overall (p < .001).
There was no gender difference in the proportion of
respondents who utilized both AUD and bipolar
Conclusions: As expected, individuals
with comorbid bipolar I disorder and AUD utilize
significantly more mental health services than
individuals with either disorder alone. The primary original
finding is that among those with comorbid bipolar I
disorder and AUD, bipolar I disorder is more likely
to go untreated among males and AUD is more likely
to go untreated among females. Gender may be an important factor to consider in future health
service planning for comorbid bipolar I disorder and AUD.