Patterns of alcohol consumption in bipolar patients comorbid for alcohol abuse or dependence
ABSTRACT Despite a high prevalence rate, patients with bipolar disorder and active alcohol use are routinely excluded from controlled clinical trials leaving clinicians with little evidence-based medicine to guide treatment. This report evaluates preliminary data of alcohol consumption patterns utilizing the Alcohol Timeline Followback (TLFB) method in actively drinking patients with bipolar disorder.
A sample of 30 patients underwent a Structured Diagnostic Interview for DSM-IV (SCID-IV) as well as completing various measures of alcohol use and associated morbidity.
In the month prior to study entry, the TLFB reported 18.4/30+/-9.12 drinking days, 9.9+/-4.73 drinks per drinking day and 169.4+/-101.71 total standard drinks for this study group. There was a significant difference in the number of drinks per drinking day between those diagnosed with rapid cycling than non-rapid cycling bipolar disorder and those with a new diagnosis versus established diagnosis of bipolar disorder.
This study highlights heavy alcohol use in patients with bipolar disorder and alcohol comorbidity. The TLFB method provides 'real world' quantification of use. Further studies are encouraged to elucidate implications of heavy drinking patterns as found in our rapid cycling and newly diagnosed cohorts.
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ABSTRACT: Despite the high rate of co-morbid alcoholism in bipolar disorder, the relationship between mood state, sex, and alcohol consumption patterns has not been well studied. An anonymous Internet survey was conducted from August 2002 to September 2005. The survey asked participants with bipolar disorder to self-report alcohol “quantity” consumed when euthymic, manic, or depressed. Of 366 persons with bipolar disorder, significantly more males (38%) than females (23%) and bipolar II (31%) than bipolar I (16%) respondents self-reported consuming a hazardous amount of alcohol during depression. These preliminary findings suggest that hazardous drinking in bipolar depression is more common in men and in patients with bipolar II disorder. Further study is encouraged to assess whether this alcohol intake increase is a possible attempt at self-medication of mood symptoms or an independent co-morbid factor related to alcoholism.Journal of Dual Diagnosis 07/2008; 4(3):291-302. DOI:10.1080/15504260802073451 · 0.80 Impact Factor
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ABSTRACT: In considering the requirements for a DEMO-relevant blanket concept, Korea (KO) has proposed a Helium Cooled Molten Lithium (HCML) Test Blanket Module (TBM) for testing in the International Thermonuclear Experimental Reactor (ITER). The performance analysis for thermal-hydraulics and safety analysis for an accident caused by loss of a coolant for the KO TBM has been carried out with a commercial CFD code, ANSYS-CFX V11 and system code, GAMMA (GAs Multicomponent Mixture Analysis). In order to verify the codes, a basic thermal-hydraulic test with a high pressure nitrogen gas loop up to 6MPa pressure and 950°C temperature was performed. In the experiment, single TBM First Wall (FW) mock-up made from the same material as the KO TBM, Ferritic Martensitic Steel, was used and the test was performed under the conditions of pressures of 20 and 36bar and flow rates of 0.75 and 0.92kg/min. As one-side of the mock-up was heated to 230°C, the wall temperatures were measured by installed thermocouples. The measured temperatures show a strong parity with codes’ results simulated with the same test conditions. An additional test with higher pressure and temperature has been prepared for the future.Fusion Engineering and Design 12/2010; 85(10):2160-2164. DOI:10.1016/j.fusengdes.2010.08.024 · 1.15 Impact Factor
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ABSTRACT: Patients with dual diagnosis are often excluded from clinical trials although more than half of all individuals with Bipolar Disorder have a substance abuse problem at some point in their lifetime, representing a high-risk clinical population. The purpose of this study was to investigate the safety and efficacy of quetiapine in the treatment of alcohol dependence comorbid with disorders characterized by high levels of mood and behavioral instability. Twenty-eight subjects, after a detoxification period, were orally treated with flexible doses of quetiapine for 16 weeks. At each assessment patients were evaluated through the Obsessive Compulsive Drinking Scale (OCDS), the Visual Analogue Scale (VAS) for craving, the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar), the Brief Psychiatric Rating Scale (BPRS), the Hamilton Depression Rating Scale (HDRS), the Young Mania Rating Scale (YMRS), and the Clinical Global Impression (CGI) scale. Forty-three percent of patients remained totally alcohol free, 32% patients relapsed, with an average of 15.4 drinking days in the period of the study (112 days) and 25% dropped-out. Significant reductions from baseline to exit were observed in the OCDS, VAS, BPRS, HDRS, and number of drinking days per week. Changes in alcohol craving correlated with psychiatric symptoms as to BPRS and HDRS, with the highest level of correlation evidenced for the HDRS items of insomnia. In this open-label study, quetiapine decreased alcohol consumption, craving for alcohol, and psychiatric symptoms intensity, maintaining a good level of tolerance. A strength of this study is that the use of quetiapine was not adjunctive with other pharmacological and non-pharmacological treatment. Double-blind placebo-controlled studies are required with a larger study population to confirm these data. In the meantime, for a select group of psychiatric patients, quetiapine may offer some advantages in preventing relapse.Human Psychopharmacology Clinical and Experimental 07/2008; 23(5):417-24. DOI:10.1002/hup.944 · 1.85 Impact Factor