title: Prevalence and clinical correlates of alcohol use disorders among bipolar disorder patients: results from the Brazilian Bipolar Research Network.
abstract: OBJECTIVE
  To investigate prevalence rates and clinical correlates of alcohol use disorders (AUD) among bipolar disorder (BD) patients in a large sample from the Brazilian Bipolar Research Network.
  
  
  METHODS
  Four hundred and eighty-three DSM-IV BD patients, divided according to the presence or absence of a lifetime AUD diagnosis (BD-AUD vs. BD-nonAUD), were included. Demographic and clinical characteristics of these two groups were compared. Logistic regression was performed to identify which characteristics were most strongly associated with a lifetime AUD diagnosis.
  
  
  RESULTS
  Nearly 23% presented a lifetime AUD diagnosis. BD-AUD patients were more likely to be male, to present rapid cycling, post-traumatic stress disorder (PTSD), anorexia, other substance use disorders (SUD), family history of SUD, any substance misuse during the first mood episode, history of psychosis, suicide attempts, and younger age at onset of illness than BD-nonAUD patients. Logistic regression showed that the variables most strongly associated with a lifetime AUD diagnosis were SUD (non-alcohol), any substance misuse during the first mood episode, PTSD, male gender, suicide attempt, family history of SUD, and younger age at onset of BD.
  
  
  CONCLUSIONS
  BD-AUD patients begin their mood disorder earlier and present more suicidal behaviors than BD-nonAUD patients. Personal and family history of SUD may be good predictors of comorbid AUD among BD patients. These variables are easily assessed in the clinical setting and may help to identify a particularly severe subgroup of BD patients.
authors.affiliation: Bipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil. Electronic address: fabiano_nery@hotmail.com.
authors.forename: Fabiano G
authors.initials: FG
authors.lastname: Nery
authors.affiliation: Mood and Anxiety Disorders Program (CETHA), Department of Neurosciences and Mental Health, Federal University of Bahia, Salvador, Bahia, Brazil.
authors.forename: Angela
authors.initials: A
authors.lastname: Miranda-Scippa
authors.affiliation: Mood and Anxiety Disorders Program (CETHA), Department of Neurosciences and Mental Health, Federal University of Bahia, Salvador, Bahia, Brazil.
authors.forename: Fabiana
authors.initials: F
authors.lastname: Nery-Fernandes
authors.affiliation: Bipolar Disorder Program (PROTAHBI), Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Flavio
authors.initials: F
authors.lastname: Kapczinski
authors.affiliation: Bipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Beny
authors.initials: B
authors.lastname: Lafer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019973:Alcohol-Related Disorders / Q000453:epidemiology*; D001714:Bipolar Disorder / Q000453:epidemiology*; D001938:Brazil / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D055815:Young Adult