Ahalya Thinaharan1, Sabitha Venkateswaran2, Shanthi Maheswari Mahalingam3
BACKGROUND
Comorbidity of bipolar disorder and substance use disorder is common. It is difficult to treat bipolar disorder patients with comorbid alcohol use disorder since the disease course is more severe and they have greater difficulties in cognitive functions than those without alcohol use. Whether alcohol negatively affects specific cognitive functions or the deficits are more diffuse in nature is unclear. Alcoholic bipolar patients present with high scores in openness to experience and neuroticism personality traits. Personality to an extent mediates the co-occurrence of substance use in bipolar disorder. Thus, identifying these personality traits in bipolar or substance use disorder patients, will help us to prevent the co-occurrence of the second disorder.
The aim of the study is to evaluate the clinical characteristics, personality traits and cognitive functions of patients with bipolar and comorbid alcohol use disorders.
MATERIALS AND METHODS
A sample of 100 patients, 50 with bipolar and alcohol use disorder (cases) and 50 with bipolar disorder (controls) attending tertiary care hospital outpatient department at Chennai was selected. Alcohol status was assessed using AUDIT (alcohol use disorder identification test) and SADQ (severity of alcohol dependence questionnaire). Personality was assessed using NEO-five factor inventory. Cognition was assessed using frontal lobe assessment battery, Stroop test, DSST (digit symbol substitution test) and verbal N back test.
RESULTS
The cases group had more number of hospitalisations and mixed episodes than control group. They also performed poorer on frontal lobe assessment battery, Stroop test and digit symbol substitution test. Duration of alcohol use was associated positively with total number of hospitalisations and number of episodes. The cases group scored significantly higher on the personality traits of neuroticism and openness to experience.
CONCLUSION
The study confirmed the higher prevalence of neuroticism and openness to experience personality traits in bipolar with alcohol use disorders. The number of hospitalisations and mixed episodes were increased when both the illness coexisted. This also increased the deficits in executive functions, response inhibition and processing speed in bipolar patients with comorbid alcohol use disorders.
