Comorbid Bipolar and Alcohol Use Disorder-A Therapeutic Challenge.
alcohol use disorder
atypical antipsychotics
bipolar disorder
depression
lithium
psychotherapy
valproate
Journal
Frontiers in psychiatry
ISSN: 1664-0640
Titre abrégé: Front Psychiatry
Pays: Switzerland
ID NLM: 101545006
Informations de publication
Date de publication:
2021
2021
Historique:
received:
29
01
2021
accepted:
01
03
2021
entrez:
9
4
2021
pubmed:
10
4
2021
medline:
10
4
2021
Statut:
epublish
Résumé
Comorbidity rates in Bipolar disorder rank highest among major mental disorders, especially comorbid substance use. Besides cannabis, alcohol is the most frequent substance of abuse as it is societally accepted and can be purchased and consumed legally. Estimates for lifetime comorbidity of bipolar disorder and alcohol use disorder are substantial and in the range of 40-70%, both for Bipolar I and II disorder, and with male preponderance. Alcohol use disorder and bipolarity significantly influence each other's severity and prognosis with a more complicated course of both disorders. Modern treatment concepts acknowledge the interplay between these disorders using an integrated therapy approach where both disorders are tackled in the same setting by a multi-professional team. Motivational interviewing, cognitive behavioral and socio- therapies incorporating the family and social environment are cornerstones in psychotherapy whereas the accompanying pharmacological treatment aims to reduce craving and to optimize mood stability. Adding valproate to lithium may reduce alcohol consumption whereas studies with antipsychotics or naltrexone and acamprosate did not affect mood fluctuations or drinking patterns. In summary, there is a continuous need for more research in order to develop evidence-based approaches for integrated treatment of this frequent comorbidity.
Identifiants
pubmed: 33833701
doi: 10.3389/fpsyt.2021.660432
pmc: PMC8021702
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
660432Informations de copyright
Copyright © 2021 Grunze, Schaefer, Scherk, Born and Preuss.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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