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Is the association of alcohol use disorders with major depressive disorder a consequence of undiagnosed bipolar-II disorder?

Angst, Jules ; Gamma, Alex ; Endrass, Jérôme ; Rössler, Wulf ; Ajdacic-Gross, Valdeta ; Eich, Dominique ; Herrell, Richard ; Merikangas, Kathleen Ries

In: European Archives of Psychiatry and Clinical Neuroscience, 2006, vol. 256, no. 7, p. 452-457

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    Titre
    • Is the association of alcohol use disorders with major depressive disorder a consequence of undiagnosed bipolar-II disorder?
    Auteur
    • Angst, Jules. Zurich University Psychiatric Hospital, Lenggstrasse 31, Mail Box 1931, 8032, Zurich, Switzerland
    • Gamma, Alex. Zurich University Psychiatric Hospital, Lenggstrasse 31, Mail Box 1931, 8032, Zurich, Switzerland
    • Endrass, Jérôme. Zurich University Psychiatric Hospital, Lenggstrasse 31, Mail Box 1931, 8032, Zurich, Switzerland
    • Rössler, Wulf. Zurich University Psychiatric Hospital, Lenggstrasse 31, Mail Box 1931, 8032, Zurich, Switzerland
    • Ajdacic-Gross, Valdeta. Zurich University Psychiatric Hospital, Social Psychiatry Research Group, Zurich, Switzerland
    • Eich, Dominique. Zurich University Psychiatric Hospital, Social Psychiatry Research Group, Zurich, Switzerland
    • Herrell, Richard. Department of Health and Human Services, Section on Developmental Genetic Epidemiology, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
    • Merikangas, Kathleen Ries. Department of Health and Human Services, Section on Developmental Genetic Epidemiology, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
    Type de document
    • Postprint
    Langue
    • Inglese
    Publié dans
    • European Archives of Psychiatry and Clinical Neuroscience, 2006, vol. 256, no. 7, p. 452-457. Steinkopff-Verlag; www.steinkopff.springer.de
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:319151
    Summary
    Background: There is emerging evidence that there is a spectrum of expression of bipolar disorder. This paper uses the well-established patterns of comorbidity of mood and alcohol use disorder to test the hypothesis that application of an expanded concept of bipolar-II (BP-II) disorder might largely explain the association of alcohol use disorders (AUD) with major depressive disorder (MDD). Method: Data from the Zurich study, a community cohort assessed over 6 waves from ages 20/21 to 40/41, were used to investigate the comorbidity between mood disorders and AUD. Systematic diagnostic criteria were used for alcohol abuse, alcohol dependence, MDD, and BP-II. In addition to DSM criteria, two increasingly broad definitions of BP-II were employed. Results: There was substantially greater comorbidity for the BP-II compared to major depression and for alcohol dependence compared to alcohol abuse. The broadest concept of BP-II explained two thirds of all cases of comorbidity of AUD with major depressive episodes (MDE). In fact, the broader the definition of BP-II applied, the smaller was the association of AUD with MDD, up to non-significance. In the majority of cases, the onset of bipolar manifestations preceded that of drinking problems by at least 5 years. Conclusions: The findings that the comorbidity of mood disorders with AUD was primarily attributable to BP-II rather than MDD and that bipolar symptoms usually preceded alcohol problems may encourage new approaches to prevention and treatment of AUD