"We found that 1 type of alcohol had a consistently negative relationship between symptoms and disability, and that is spirits," said principal investigator Benjamin Goldstein, MD, a psychiatry resident, University of Toronto. "Each type of alcohol -- beer, wine, and spirits -- has some suggestion of having a negative effect on illness. Spirits demonstrated the strongest association." Spirits are defined as distilled rather than fermented alcoholic beverages.

In this study of 84 bipolar patients (a subset of a larger sample population), Dr. Goldstein and his colleagues found statistically significant correlations between lifetime episodes of mania and intake of alcohol spirits, as well as a statistically significant relationship between subjects who drank wine and those who experienced more friction in the workplace. Beer was found to be negatively associated with depressive symptoms.

The subjects with bipolar disorder were measured on the Hamilton Depression Rating Scale, the Clinician-Administered Rating Scale for Mania (CARS-M), the Social Adjustment Scale, and the Khavari Alcohol Test. Their age of onset for bipolar depression was 21, and two thirds were female. Nearly half (42%) were employed. Their average was 41. Subjects had to have been on a steady dose of a mood-stabiliser for at least 4 weeks.

In comparison to other demographic groups that have been surveyed, bipolar patients consumed less alcohol: Nearly two-thirds of subjects consumed less than 1 alcohol beverage per week.

"This study is not necessarily representative of all bipolar patients, but we found there to be relatively low alcohol consumption compared to other populations, such as college students and veterans," said Dr. Goldstein. "Our next step is to look at a larger sample size of patients and see if the relationship between symptoms and alcohol consumption is predictive. That sample will include [a] follow-up date through 18 months."

The researchers decided to study the impact of alcohol intake on symptoms of bipolar disorder because it is estimated that half of patients with bipolar illness suffer at one point over the course of their illness with an alcohol-use disorder, characterised by alcohol abuse or dependence.

"If you suffer from bipolar disorder and alcohol abuse or dependence at the same time, the likelihood that you will spend more time in hospital [and] have a more severe course of the illness is increased, as is the possibility of suicide and suicidal behaviours," explained Dr. Goldstein.


[Presentation title: "Alcohol Consumption in Bipolar Disorder: Impact on Six-Month Outcome Among Non-Alcoholic Patients." Abstract 50]a

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