Excessive alcohol use does not alter course of bipolar mood states

By Sarah Pritchard, medwireNews Reporter

Patients with bipolar disorder who consume alcohol do not experience significant changes in their self-reported mood states with increased consumption, show Dutch study findings.

Among women in a depressive state, each increase of 1 unit of alcohol per day over a week was associated with a significant 1.18-fold increased likelihood of switching to a euthymic state; however, the same association did not hold for male participants.

Furthermore, just 0.01% of the variance in mood severity in the cohort – as self-rated daily on the National Institute of Mental Health Life Chart Method (LCM) – could be explained by alcohol use.

The results contradict those of previous studies that indicate comorbid alcohol use disorder in bipolar patients is associated with more frequent and longer symptomatic episodes among other negative effects, say Jan van Zaane (VU University Medical Center, Amsterdam) and co-workers.

In addition, the 137 patients whose data were included in the current study were adherent to mood stabilisers, which “appears to be of the utmost importance for preventing the possible negative effects of (excessive) alcohol use on the course of [bipolar disorder]”, they suggest in Bipolar Disorders.

The cohort, 50% of whom were women, rated their mood on the LCM at the end of each day for a year, as well as their weekly intake of standard alcoholic drinks, where 1 unit equals 12 mL of pure alcohol.

A third (32%) of patients reported no alcohol or incidental alcohol intake, at 0 to 2 units per week, a third (36%) reported moderate intake, at 3 to 14 units per week for women and 3 to 21 units per week for men, and a third (32%) reported using excessive amounts of alcohol, at a minimum of 15 units for women and 22 units for men.

Overall, 8.6% of weeks studied were scored as depressed on the LCM, 2.9% as manic and 88.5% as euthymic.

While an increase in alcohol consumption appeared to reduce the time between a depressed state and a euthymic state for women in the study, increased consumption was associated with a significantly reduced likelihood of men in a euthymic state switching to a manic state, at a hazard ratio of 0.81.

Despite these significant associations, the researchers caution against their clinical relevance, particularly in view of the finding that the estimates of the within-subject correlation coefficient for the whole cohort were very small, at –0.01.

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