Increased suicidality in mania complicated by alcoholism.

Objective. This retrospective study was done to assess the impact of concurrent alcohol use on the illness presentation of patients hospitalized for mania.Design. Retrospective demographic and clinical data were systematically collected from the hospital records of 122 patients hospitalized for an index episode of mania between 1988 and 1995. Comorbid alcoholism was defined as alcohol abuse/dependence, based on DSM-IV criteria. Blind to alcohol use and treatment intervention, a retrospective clinical assessment of illness severity was made by the Clinical Global Impression (CGI) at the end point of hospital discharge. Demographic and clinical differences between the alcoholic and nonalcoholic manic subjects were analyzed by chi-square and independent t-tests. Survival analyses with hospital length of stay as the dependent variable were conducted on the two groups.Setting. Tertiary care university hospital.Participants. Patients with bipolar disorder hospitalized for mania.Measurements. Clinical Global Impression (CGI), clinical variables (suicidality, polysubstance abuse, hospital length of stay).Results. Alcoholic manic and nonalcoholic manic patients differed significantly in two categorical measures: suicidality on admission (36.7 vs. 18.5%) and current polysubstance abuse/dependence (46.6 vs. 7.6%). There was no significant difference in length of hospitalization between the two groups.Conclusions. The results of this study are consistent with previous studies that have found an association between alcoholism and increased suicidality and polysubstance abuse in bipolar disorder.