title: [Comorbidity of affective disorders and alcohol use disorder].
abstract: The comorbidity of affective disorders with alcohol use disorder remains insufficiently taken into account. In spite of the well-known frequency of the addict comorbidity in most psychiatric disorders, the level of association between affective disorders and alcohol is still underestimated and poorly understood. The label of "double diagnosis" relates to a simple addition of two independent pathologies. It is suggested to consider a "dual psychopathology" combining the effects of one disorder on the other. Interactions between the two disorders commit a complex state calling a new clinical reading, an adapted therapeutic strategy through a necessary integration of care. Association of alcohol use disorder and affective disorder, particularly in bipolar disorders, is correlated with severity, unstable course, treatment resistance and a greater risk of suicide. Alcohol aggravates depression and hampers therapeutics. Alcohol and mania remain a dreaded danger. The mechanism of the comorbid association does not only refer to a behavioral strategy of compensation but seems strongly based on a shared and crossed vulnerability, related to the genetics of the 5HT carrier and gene Clock. Therapeutic limitations do suggest the implementation of an "integrated" device which supposes a new organization of care and facilitation of collaborations between Addiction and Psychiatry.
authors.affiliation: Faculté de Médecine de Nice - UNSA - 28 avenue de Vallombrose 06107 Nice, France. Electronic address: pringuey@unice.fr.
authors.forename: D
authors.initials: D
authors.lastname: Pringuey
authors.affiliation: Faculté de Médecine de Nice - UNSA - 28 avenue de Vallombrose 06107 Nice, France.
authors.forename: F
authors.initials: F
authors.lastname: Cherikh
authors.affiliation: Faculté de Médecine de Nice - UNSA - 28 avenue de Vallombrose 06107 Nice, France.
authors.forename: S
authors.initials: S
authors.lastname: Lunacek
authors.affiliation: Faculté de Médecine de Nice - UNSA - 28 avenue de Vallombrose 06107 Nice, France.
authors.forename: B
authors.initials: B
authors.lastname: Giordana
authors.affiliation: SHU Psychiatrie adultes, Solaris, Hôpital Ste Marguerite, 13274 Marseille cedex 9, France.
authors.forename: E
authors.initials: E
authors.lastname: Fakra
authors.affiliation: SHU Psychiatrie adultes, Solaris, Hôpital Ste Marguerite, 13274 Marseille cedex 9, France.
authors.forename: R
authors.initials: R
authors.lastname: Belzeaux
authors.affiliation: SHU Psychiatrie adultes, Solaris, Hôpital Ste Marguerite, 13274 Marseille cedex 9, France.
authors.forename: M
authors.initials: M
authors.lastname: Adida
authors.affiliation: SHU Psychiatrie adultes, Solaris, Hôpital Ste Marguerite, 13274 Marseille cedex 9, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Azorin
mesh_terms: D000437:Alcoholism / Q000175:diagnosis* / Q000453:epidemiology* / Q000235:genetics; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D056926:CLOCK Proteins / Q000235:genetics; D015897:Comorbidity; D003430:Cross-Sectional Studies; D017831:Diagnosis, Dual (Psychiatry); D005602:France; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006801:Humans; D033183:Interdisciplinary Communication; D019964:Mood Disorders / Q000175:diagnosis* / Q000235:genetics / Q000523:psychology*; D012307:Risk Factors; D050486:Serotonin Plasma Membrane Transport Proteins / Q000235:genetics; D013405:Suicide / Q000523:psychology
chemical_list: D050486:Serotonin Plasma Membrane Transport Proteins; D056926:CLOCK Proteins; C538943:CLOCK protein, human
keywords: Affective disorders; Alcohol use disorder; Comorbidité psychiatrique; Psychiatric comorbidity; Troubles affectifs; Troubles liés à l’usage de l’alcool; Vulnerability factors; Vulnérabilité