Bipolar patients with alcohol consumption will have more relapses?: a 5 year follow-up study

Abstract

Background. Alcohol use disorder (AUD) occurs at high rates in Bipolar disorder (BD).

However, the reasons of this co-occurrence are unknown. It is estimated that 46.2% of bipolar I patients had a lifetime history of AUD. Alcohol is strongly associated with maintaining or developing affective symptoms and could act as course or episode modifier of BD. The association of these two disorders can influence on the onset, the duration, on the progression and on the time of recovery of the episode. It is associated with poor symptomatic, with more hospitalizations and with poor response to the treatment. Also, it increases the psychosocial stress and residual, irritability, depressive and anxiety symptoms. Has influence on sleep and circadian rhythm and increases the risk of morbidity and chronicity of the disorder. All of these factors can lead to more relapses and to a shorter time between episodes. Although BD is one of the most severe chronic mental illnesses and it has been hypothesized that bipolar patients who have an alcohol consumption will have more relapses than those who don’t have this alcohol consumption.

Aim. Determine if the bipolar patients who have an alcohol consumption will have more relapses than those who don’t have this alcohol consumption, using the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) criteria for depression, mania and mixed features, in order to classify the patients as “relapse” and “no relapse” and determine if patients have a relapse or don’t.

Methods. This study will be a prospective cohort study, which will include ninety patients with bipolar disorder, from “Xarxa de Salut Mental” de Girona, using a consecutive sequential sampling. These patients will be followed for 5 years, after being assigned two separate groups, according to their scores in the CAGE questionnaire (≥2 o <2) (independent variable). Relapses will be the dependent variable, measured with, the DSM-5 criteria for depression, mania and mixed features at the 6, 12, 18, 24, 30, 36, 42, 48, 54 and 60 months mark. Frequencies, percentages, mean±SD, Fisher’s exact test, Student’s t-test, logistic regression analysis and general lineal model will be performed to analyse and describe the results of the study