BACKGROUND: There is emerging evidence that there is a spectrum of expression of bipolar disorder. This paper uses the well-established patterns of comorbidity of mood and alcohol use disorder to test the hypothesis that application of an expanded concept of bipolar-II (BP-II) disorder might largely explain the association of alcohol use disorders (AUD) with major depressive disorder (MDD). METHOD: Data from the Zurich study, a community cohort assessed over 6 waves from ages 20/21 to 40/41, were used to investigate the comorbidity between mood disorders and AUD. Systematic diagnostic criteria were used for alcohol abuse, alcohol dependence, MDD, and BP-II. In addition to DSM criteria, two increasingly broad definitions of BP-II were employed. RESULTS: There was substantially greater comorbidity for the BP-II compared to major depression and for alcohol dependence compared to alcohol abuse. The broadest concept of BP-II explained two thirds of all cases of comorbidity of AUD with major depressive episodes (MDE). In fact, the broader the definition of BP-II applied, the smaller was the association of AUD with MDD, up to non-significance. In the majority of cases, the onset of bipolar manifestations preceded that of drinking problems by at least 5 years. CONCLUSIONS: The findings that the comorbidity of mood disorders with AUD was primarily attributable to BP-II rather than MDD and that bipolar symptoms usually preceded alcohol problems may encourage new approaches to prevention and treatment of AUD.
BACKGROUND: There is emerging evidence that there is a spectrum of expression of bipolar disorder. This paper uses the well-established patterns of comorbidity of mood and alcohol use disorder to test the hypothesis that application of an expanded concept of bipolar-II (BP-II) disorder might largely explain the association of alcohol use disorders (AUD) with major depressive disorder (MDD). METHOD: Data from the Zurich study, a community cohort assessed over 6 waves from ages 20/21 to 40/41, were used to investigate the comorbidity between mood disorders and AUD. Systematic diagnostic criteria were used for alcohol abuse, alcohol dependence, MDD, and BP-II. In addition to DSM criteria, two increasingly broad definitions of BP-II were employed. RESULTS: There was substantially greater comorbidity for the BP-II compared to major depression and for alcohol dependence compared to alcohol abuse. The broadest concept of BP-II explained two thirds of all cases of comorbidity of AUD with major depressive episodes (MDE). In fact, the broader the definition of BP-II applied, the smaller was the association of AUD with MDD, up to non-significance. In the majority of cases, the onset of bipolar manifestations preceded that of drinking problems by at least 5 years. CONCLUSIONS: The findings that the comorbidity of mood disorders with AUD was primarily attributable to BP-II rather than MDD and that bipolar symptoms usually preceded alcohol problems may encourage new approaches to prevention and treatment of AUD.
Authors: K R Merikangas; J Angst; W Eaton; G Canino; M Rubio-Stipec; H Wacker; H U Wittchen; L Andrade; C Essau; A Whitaker; H Kraemer; L N Robins; D J Kupfer Journal: Br J Psychiatry Suppl Date: 1996-06
Authors: Bridget F Grant; Deborah A Dawson; Frederick S Stinson; Patricia S Chou; Ward Kay; Roger Pickering Journal: Drug Alcohol Depend Date: 2003-07-20 Impact factor: 4.492
Authors: Philippe Nubukpo; Murielle Girard; Jean-Marie Sengelen; Sophie Bonnefond; Aurélien Varnoux; Benoît Marin; Dominique Malauzat Journal: Ann Gen Psychiatry Date: 2016-08-31 Impact factor: 3.455
Authors: Sally I Sharp; Andrew McQuillin; Michael Marks; Stephen P Hunt; S Clare Stanford; Greg J Lydall; Marsha Y Morgan; Philip Asherson; David Curtis; Hugh M D Gurling Journal: Am J Med Genet B Neuropsychiatr Genet Date: 2014-05-09 Impact factor: 3.568