Original Research April 2026
Differences in the Severity of Alcohol Craving Between Euthymic Unipolar and Bipolar Patients
PCC CNS Disord 2026;28(2):10.4088/PCC.25m04123
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Key Takeaways

From the Authors As published in the article
  1. Assess mood disorder subtype: Craving and alcohol-related severity differ between major depressive disorder and bipolar disorder even during euthymia, so accurate diagnosis is crucial.
  2. Use biomarkers to guide care: Plasma homocysteine and carbohydrate-deficient transferrin can help identify high-risk patients and support personalized, integrated treatment strategies.
Extended Takeaways
  1. This study enrolled 50 euthymic patients with dual diagnosis, including 31 with major depressive disorder and 19 with bipolar disorder, so the observed diagnostic differences reflect a clinically stable outpatient population rather than an acutely symptomatic mood episode.
  2. Mood euthymia was operationalized with Montgomery-Asberg Depression Rating Scale scores of ≤4 and Young Mania Rating Scale scores of <12, which helps clinicians interpret the higher craving burden in the major depressive disorder group as persisting despite minimal current mood symptoms.
  3. In both diagnostic groups, alcohol craving severity tracked with AUDIT scores, CDT, and plasma homocysteine, suggesting that a high VAS score during routine follow-up should prompt careful assessment of concurrent alcohol-related severity and biologic risk markers.
  4. No significant correlations were found between VAS scores and age, gender, education level, or employment status in either group, so readily available demographic factors were less informative than alcohol-use measures and laboratory markers for identifying patients with greater craving.
  5. The bipolar sample included both BD I and BD II (5 BD I and 14 BD II), which means clinicians should be cautious about assuming the same craving profile across bipolar subtypes when applying these findings in practice.
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