Influence of Alcohol Dependence on the Clinical and Dynamic Characteristics of Bipolar Disorder with Their Comorbidity in Psychiatric Hospital Patients

   Background: numerous studies indicate a high level of comorbidity of bipolar disorder with other psychiatric disorders. Alcohol dependence is one of the most common comorbid pathologies, along with anxiety disorders and personality disorders.   Objective: determination of the frequency of comorbidity of BAR with alcohol dependence in patients of a specialized psychiatric hospital and identiашcation of clinical and dynamic features of BAR with this comorbidity.   Patients and methods: in the psychiatric unit, 188 patients with bipolar disorder diagnosed according to ICD-10 (136 women and 52 men) were examined. The age of female patients was 41.6 ± 14.4 years, male — 39.4 ± 14.0 years. Depending on the current affective disorder, patients were distributed as follows: a depressive episode — 62.2 % (n = 117), a hypomanic episode — 2.7 % (n = 5), a manic episode (ME) — 1.6 % (n = 3), mixed episode — 33.5 % (n = 63). A comparative assessment of the clinical and dynamic characteristics of bipolar disorder was carried out in 2 groups of patients: with bipolar disorder and comorbid alcohol dependence — 30 individuals (14 women and 16 men), aged 43 years [29; 55] and without comorbidity with alcohol dependence — 59 individuals (39 women and 20 men), age 36 years [29; 50]. During the study, clinical-psychopathological, clinical-catamnestic, psychometric, statistical methods were used.   Results and discussion: the level of comorbidity of bipolar disorder with alcohol dependence was determined — 15.9 %. It was found that in BD with comorbid alcohol dependence, compared with BD without alcohol dependence, patients have an early onset age of BD, more often have mixed episodes during an affective disorder. In addition, such patients have a higher risk of suicidal behavior, bipolar-I, and exacerbation of affective symptoms. It has also been shown that alcohol dependence makes it difficult to recognize bipolar disorder during the primary visit to specialized psychiatric care.   Conclusion: addition of alcohol dependence to bipolar disorder affects negatively its main clinical and dynamic parameters and delays the terms of its diagnostics.