title: Psychological Outcomes and Medical Morbidity of Patients With Bipolar Disorder and Co-Occurring Alcohol Use Disorder.
abstract: OBJECTIVE
  Patients with bipolar disorder are at a high risk for comorbid alcohol use disorder, and both disorders are associated with poor outcomes and multiple morbidities. This study aimed to explore not only the psychosocial functioning and psychopathological outcomes but also the medical morbidity of patients with bipolar disorder with and without alcohol use disorder.
  
  
  METHODS
  Outpatients with bipolar I disorder (DSM-IV) were recruited from a psychiatric teaching hospital in Taiwan (N = 393). Data on psychiatric symptoms, psychosocial functioning, and physical health were obtained through interviews with patients and collaterals, patient self-report, and medical record reviews.
  
  
  RESULTS
  Participants had a mean age of 41.1 years (SD = 11.9) and were mostly female (n = 255, 64.9%). Fewer than 10% (n = 34, 8.7%) met criteria for alcohol use disorder, and these participants were more likely to be male, to smoke, and to have a history of rapid cycling, higher mean body mass index, and higher incidences of gastrointestinal and hepatobiliary morbidities. A multiple logistic regression analysis revealed that patients with, versus those without, alcohol use disorder were more prone to gastrointestinal diseases (adjusted OR = 4.25, 95% CI [1.44-12.53], p <.01), hepatobiliary diseases (adjusted OR = 3.14, 95% CI [1.20-8.25], p <.025), and history of rapid cycling (adjusted OR = 2.53, 95% CI [0.91-7.01], p <.075).
  
  
  CONCLUSIONS
  Comorbid alcohol use disorders may have a stronger impact on physical health than on psychosocial or psychopathological outcomes of patients with bipolar disorder.
authors.affiliation: a Department of Psychiatry and Psychiatric Research Center , Taipei Medical University Hospital , Taipei , Taiwan.|b Department of Psychiatry , School of Medicine, College of Medicine, Taipei Medical University , Taipei , Taiwan.
authors.forename: Han-Ching
authors.initials: HC
authors.lastname: Tang
authors.affiliation: a Department of Psychiatry and Psychiatric Research Center , Taipei Medical University Hospital , Taipei , Taiwan.|b Department of Psychiatry , School of Medicine, College of Medicine, Taipei Medical University , Taipei , Taiwan.
authors.forename: Pao-Huan
authors.initials: PH
authors.lastname: Chen
authors.affiliation: a Department of Psychiatry and Psychiatric Research Center , Taipei Medical University Hospital , Taipei , Taiwan.|b Department of Psychiatry , School of Medicine, College of Medicine, Taipei Medical University , Taipei , Taiwan.
authors.forename: Kuo-Hsuan
authors.initials: KH
authors.lastname: Chung
authors.affiliation: b Department of Psychiatry , School of Medicine, College of Medicine, Taipei Medical University , Taipei , Taiwan.|c Taipei City Psychiatric Center, Taipei City Hospital, Songde Branch , Taipei , Taiwan.
authors.forename: Chian-Jue
authors.initials: CJ
authors.lastname: Kuo
authors.affiliation: a Department of Psychiatry and Psychiatric Research Center , Taipei Medical University Hospital , Taipei , Taiwan.|b Department of Psychiatry , School of Medicine, College of Medicine, Taipei Medical University , Taipei , Taiwan.
authors.forename: Shou-Hung
authors.initials: SH
authors.lastname: Huang
authors.affiliation: a Department of Psychiatry and Psychiatric Research Center , Taipei Medical University Hospital , Taipei , Taiwan.|b Department of Psychiatry , School of Medicine, College of Medicine, Taipei Medical University , Taipei , Taiwan.
authors.forename: Shang-Ying
authors.initials: SY
authors.lastname: Tsai
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000150:complications / Q000523:psychology*; D001714:Bipolar Disorder / Q000150:complications / Q000523:psychology*; D015992:Body Mass Index; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D005767:Gastrointestinal Diseases / Q000150:complications*; D006801:Humans; D008107:Liver Diseases / Q000150:complications*; D008297:Male; D008875:Middle Aged; D057566:Self Report; D012737:Sex Factors; D012907:Smoking / Q000523:psychology*
keywords: alcohol use disorders; bipolar disorder; comorbidity; gastrointestinal diseases; outcome