Bipolar disorder is associated with alcohol- and substance-use disorders, which are associated with a worse clinical course.1-4 However, the exact nature of the interaction is not clear, because there appears to be at least a partly bidirectional relationship.4 Ultimately, more research is needed to form a good evidence base for making treatment decisions for people with bipolar disorder and comorbid alcohol- or substance-use disorder.4
References:
1. Hunt GE, Malhi GS, Cleary M, et al. Prevalence of comorbid bipolar and substance use disorders in clinical settings, 1990–2015: systematic review and meta-analysis. J Affect Disord 2016; 206: 331–349.
2. Hunt GE, Malhi GS, Cleary M, et al. Comorbidity of bipolar and substance use disorders in national surveys of general populations, 1990–2015: systematic review and meta-analysis. J Affect Disord 2016; 206: 321–330.
3. Di Florio A, Craddock N, van den Bree M. Alcohol misuse in bipolar disorder. A systematic review and meta-analysis of comorbidity rates. Eur Psychiatry 2014; 29 (3): 117–124.
4. Grunze H, Schaefer M, Scherk H, et al. Comorbid bipolar and alcohol use disorder – a therapeutic challenge. Front Psychiatry 2021; 12: 660432.