ALCOHOL-PROBLEMS AND LONG-TERM PSYCHOSOCIAL OUTCOME IN CHINESE PATIENTS WITH BIPOLAR DISORDER

Background: A high comorbidity of alcohol use disorders among Western bipolar patients is recognized and worsens the outcome of bipolar illn ess. In view of lower prevalence of alcohol use disorders in some Asia n groups, we attempted to investigate the alcohol problems among Chine se bipolar patients in Taiwan. Methods: The clinical data of bipolar p atients (DSM-III-R) having been followed-up naturally for at least 15 years were obtained by a combination of chart reviews and interviews w ith patients and family members. Results: Rased on a retrospective cha rt review of 158 patients, 8.2% of them were found to have alcohol pro blems. The lifetime prevalence of alcohol abuse was 6.9%, and of alcoh ol dependence 3.0% among 101 subjects accepting interview. According t o the Global Assessment of Functioning Scale (APA, 1994) nearly one-th ird of them were clearly dysfunctional. Limitation: As subjects had a greater mean age, the age-related effects probably worsened the psycho social outcome and reduced the incidence of new substance abuse. Concl usion: Chinese bipolar patients, despite a lower comorbidity of alcoho l use disorders, do not have a more favorable long-term psychosocial o utcome(marriage, work, and social adjustment) than Western patients. ( C) 1997 Elsevier Science B.V.