title: Neuropsychological functions in bipolar disorders I and II with and without comorbid alcohol dependence.
abstract: OBJECTIVE
  Bipolar disorder (BP) is a mental disorder most likely to co-occur with substance dependence and abuse, especially alcohol dependence (ALD). Whether the effect of comorbid alcoholism is different between the BP-I and BP-II subtypes remains unclear. We aimed to identify the neuropsychological performance of BP patients with and without comorbid ALD in partial remission from depression or mania, and compare it with that of healthy controls (HCs).
  
  
  METHODS
  We recruited 29 HCs and 94 BP patients, whom we categorized into four groups: (1) BP-I without a history of alcohol abuse or dependence (BP-I(-ALD); n=22), (2) BP-II without a history of alcohol abuse and dependence (BP-II(-ALD); n=38), (3) BP-I with comorbid ALD (BP-I(+ALD); n=16), and (4) BP-II with comorbid ALD (BP-II(+ALD); n=18). Only males were recruited in this study.
  
  
  RESULTS
  When patients comorbid with ALD were not excluded, there were no significant differences on neuropsychological tests between the BP-I and BP-II groups. However, when patients with comorbid ALD were excluded, there were significant differences between the two BP(-ALD) groups. The BP-I(-ALD) group had lower scores on memory subtests (p≤0.01) than the HC and BP-II(-ALD) groups, but the BP-II(-ALD) and HC groups had similar scores.
  
  
  CONCLUSIONS
  We found it important to exclude ALD comorbidity when evaluating neuropsychological functions due to our finding that ALD affected the cognitive performance in BP-I more severely than in the BP-II group. ALD not only impairs neuropsychological function, but also worsen the clinical course and leads to a more pernicious status and negative cycle.
authors.affiliation: Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Yun-Hsuan
authors.initials: YH
authors.lastname: Chang
authors.forename: Shiou-Lan
authors.initials: SL
authors.lastname: Chen
authors.forename: Sheng-Yu
authors.initials: SY
authors.lastname: Lee
authors.forename: Yu-Wen
authors.initials: YW
authors.lastname: Hsu
authors.forename: Jo Yung-Wei
authors.initials: JY
authors.lastname: Wu
authors.forename: Shih-Heng
authors.initials: SH
authors.lastname: Chen
authors.forename: Chun-Hsien
authors.initials: CH
authors.lastname: Chu
authors.forename: I Hui
authors.initials: IH
authors.lastname: Lee
authors.forename: Tzung Lieh
authors.initials: TL
authors.lastname: Yeh
authors.forename: Nian-Sheng
authors.initials: NS
authors.lastname: Tzeng
authors.forename: San-Yuan
authors.initials: SY
authors.lastname: Huang
authors.forename: Yen Kuang
authors.initials: YK
authors.lastname: Yang
authors.forename: Ru-Band
authors.initials: RB
authors.lastname: Lu
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000150:complications / Q000523:psychology*; D001288:Attention; D001714:Bipolar Disorder / Q000150:complications / Q000523:psychology*; D003071:Cognition; D056344:Executive Function; D006801:Humans; D008297:Male; D008568:Memory; D008875:Middle Aged; D009483:Neuropsychological Tests