title: The effects of ethnic, social and cultural factors on axis I comorbidity of bipolar disorder: results from the clinical setting in Korea.
abstract: OBJECTIVE
  Ethnic, social and cultural factors contribute to axis I comorbid conditions in bipolar disorder (BPD). Korea has strict laws against illicit drugs and a relatively permissive prevailing attitude toward alcohol. The present study aimed to explore the lifetime axis I comorbidity rate in patients with BPD in Korea.
  
  
  METHODS
  Clinically stable patients with bipolar I (n=222) and bipolar II (n=194) disorders were recruited from four tertiary medical centers in Korea. The subjects׳ diagnoses and axis I comorbid conditions were evaluated using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) and the Korean version of the Diagnostic Interview for Genetic Studies (K-DIGS). The lifetime prevalence of anxiety disorders, substance use disorders and eating disorders was explored. The prevalence of these axis I comorbid conditions was compared with data from prior studies in other countries and to data concerning the general Korean population.
  
  
  RESULTS
  A total of 45.1% of all subjects had at least one axis I comorbid condition. Anxiety disorders (30.2%) were the most common comorbidity, followed by alcohol use disorders (16.8%). Males with BPD showed a higher rate of alcohol dependence compared to the general male population and females with BPD showed a greater risk of having alcohol use disorder compared to the general female population. The rate of drug use disorder was extremely low (1.7%), and only one subject had an illicit-drug-related problem.
  
  
  CONCLUSIONS
  Cross-sectional studies.
  
  
  CONCLUSIONS
  Comorbid conditions of Korean patients with BPD showed a distinct pattern, which is associated with the ethnic, social and cultural characteristics in Korea.
authors.affiliation: Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea; Department of Neuropsychiatry, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Kyunggi-Do, Republic of Korea.
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Baek
authors.affiliation: Department of Psychiatry, Gyeongsang National University College of Medicine, Jinju, Republic of Korea.
authors.forename: Boseok
authors.initials: B
authors.lastname: Cha
authors.affiliation: Department of Psychiatry, Pusan National University College of Medicine, Pusan, Republic of Korea.
authors.forename: Eunsoo
authors.initials: E
authors.lastname: Moon
authors.affiliation: Department of Neuropsychiatry, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Kyunggi-Do, Republic of Korea.
authors.forename: Tae Hyon
authors.initials: TH
authors.lastname: Ha
authors.affiliation: Department of Neuropsychiatry, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Kyunggi-Do, Republic of Korea.
authors.forename: Jae Seung
authors.initials: JS
authors.lastname: Chang
authors.affiliation: Department of Neuropsychiatry, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Kyunggi-Do, Republic of Korea.
authors.forename: Jeong Hyun
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Psychiatry, Seoul Municipal Eunpyeong Hospital, San6 Eungam2-Dong, Eunpyeong-Gu, Seoul 122-913, Republic of Korea.
authors.forename: Jung Eun
authors.initials: JE
authors.lastname: Choi
authors.affiliation: Department of Neuropsychiatry, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Kyunggi-Do, Republic of Korea.
authors.forename: Bong Jin
authors.initials: BJ
authors.lastname: Kang
authors.affiliation: Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea.
authors.forename: Kyung Sue
authors.initials: KS
authors.lastname: Hong
authors.affiliation: Department of Neuropsychiatry, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Kyunggi-Do, Republic of Korea; Seoul National Hospital, Seoul, Republic of Korea. Electronic address: kyooha@snu.ac.kr.
authors.forename: Kyooseob
authors.initials: K
authors.lastname: Ha
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000208:ethnology*; D001714:Bipolar Disorder / Q000175:diagnosis / Q000208:ethnology*; D003430:Cross-Sectional Studies; D003466:Cultural Characteristics; D039721:Diagnostic and Statistical Manual of Mental Disorders; D001068:Feeding and Eating Disorders / Q000208:ethnology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea; D012924:Social Conditions; D019966:Substance-Related Disorders / Q000208:ethnology*
keywords: Axis I comorbidity; Bipolar disorder; Ethnic difference; Transcultural psychiatry