Abstract：【Objective】To investigate the clinical characteristics and influencing factors of bipolar disorder comorbid with alcohol use disorder.【Methods】Patients with bipolar disorder who were hospitalized at the Hebei Mental Health Center were divided into comorbid groups (n=51) and non-comorbid groups (n=97) according to the status of comorbid alcohol use disorders. The diagnostic criteria were based on the Diagnostic and Statistical Manual of Mental Disorders in the United States (the fifth revised edition, DSM-5). At the same time, general situation questionnaire and response questionnaire were used to survey the subjects and analyze the relevant factors.【Results】There were differences between the comorbid group and the non-comorbid group in terms of gender, education level, family relationship, occupation, pre-disease personality, family history of alcoholism, and the onset of disease (P< 0.05). In various risk assessments, impulsive behavior and self-injury behavior of the comorbid group were higher than those of the non-comorbid group, and the difference was statistically significant (P<0.05). The score of problem-solving approach style in the comorbid group was lower than that in the non-comorbid group(P<0.05), while the self-blame coping style of the comorbid group was higher than that of the non-comorbid group(P<0.05). Unconditional multivariate Logistic regression analysis showed that male, impulsive behavior, acute and subacute onset were risk factors for comorbid alcohol use disorder(P<0.05), while elementary education and below, high school / secondary education, workers, farmers, and introverted personality before illness were protective factors for comorbid alcohol use disorder (P<0.05).【Conclusion】The proportion of comorbid alcohol use disorder in hospitalized patients with bipolar disorder is not low at all. The comorbid patients are less likely to adopt problem-solving approaches, instead they have a higher risk of impulsive behavior.
严保平, 李薇, 张贤峰, 桑文华, 李冰. 双相情感障碍共病酒精使用障碍患者的临床特征及影响因素[J]. 医学临床研究, 2020, 37(2): 171-173.
YAN Bao-ping, LI Wei, ZHANG Xian-feng,et al. Study on Clinical Characteristics and Influencing Factors of Bipolar Disorder Comorbid with Alcohol Use Disorder. JOURNAL OF CLINICAL RESEARCH, 2020, 37(2): 171-173.
[1] 陆林.沈渔邨精神病学[M].第6版.北京:人民卫生出版社,2017:355-356. [2] Fossey MD, Otto MW, Yates WR,et al. Validity of the distinction between primary and secondary substance use disorder in patients with bipolar disorder: data from the first 1000 STEP-BD participants[J].Am J Addict,2006, 15(2): 138-143. [3] Oquendo MA, Currier D, Liu S, et al. Increased risk for suicidal behavior in comorbid bipolar disorder and alcohol use disorders [J] .J Clin Psychiatry,2010 ,71(7): 902-909. [4] 美国精神医学学会. 精神障碍诊断与统计手册[M].第五版.张道龙,译. 北京:北京大学出版社,2015. [5] 汪向东,王希林,马弘.心理卫生评定量表手册[M].北京:中国心理卫生杂志社,1999(增):109-115. [6] Carmiol N, Peralta JM, Almasy L,et al. Shared genetic factors influence risk for bipolar disorder and alcohol use disorders [J] .Eur Psychiatry,2014,29(5): 282-287. [7] Klimkiewicz A,Klimkiewicz J,Jakubczyk A,et al. Comorbidity of alcohol dependence with other psychiatric disorders. Part I. Epidemiology of dual diagnosis[J].Psychiatr Pol,2015, 49(2): 265-275. [8] 谭奔腾.长沙地区社区人群中酒精使用障碍与心境障碍的共病[D].长沙:中南大学,2013. [9] Nery FG, Matsuo K, Nicoletti, et al.Association between prior alcohol use disorders and decreased prefrontal gray matter volumes in bipolar I disorder patients [J].Neurosci Lett,2011,503(2):136-140. [10] Chitty KM, Lagopoulos J, Kaur M, et al.The N-Methyl-D-Aspartate receptor as a neurobiological intersection between bipolar disorder and alcohol use:a longitudinal mismatch negativity study[J].Int J Neuropsychopharmacol, 2015,18(6),1-9. [11] Brown ES,Carmody TJ, Schmitz JM, et al. A Randomized, Double-Blind, Placebo-Controlled pilot study of naltrexone in outpatients with bipolar disorder and alcohol dependence[J].Alcohol Clin Exp Res,2009 , 33(11): 1863-1869. [12] Farren CK, Hill KP, Weiss RD. Bipolar disorder and alcohol use disorder:a review [J].Curr Psychiatry Rep,2012,14(6): 659-666. [13] 迟勇,陈旭. 120例酒精依赖共病双相障碍患者临床特征分析[J].中国药物依赖性杂志,2016,25(2) :202-205.
2020, Vol. 37 
