Comorbidity of alcohol dependence with other psychiatric disorders. Part I. Epidemiology of dual diagnosis

Abstract

The paper is a review of the literature on the comorbidity of alcohol dependence with other psychiatric disorders. A condition when alcohol dependence is accompanied by another mental disorder is much more common than it is commonly believed. It is estimated that more than one third of people diagnosed with mental disorders, abuses or is dependent on psychoactive substances, especially alcohol; among alcohol-dependent patients 37% suffer from other mental disorders. Alcohol dependence is associated with increased risk of mood disorders - more than three times higher, depression - almost four times higher, bipolar disorder - more than six times higher, anxiety disorders in general - more than twice, generalized anxiety disorder - more than four times higher, panic disorders - almost double, posttraumatic stress disorder - more than twice. Underestimating of comorbidity is an important problem during treatment of such population of patients. Social skills training can improve a stress management and decrease alcohol and drug use among dual diagnosed patients.

Cribaje de trastornos por uso de alcohol en pacientes psiquiátricos ambulatorios: influencia de género, edad, y diagnóstico psiquiátrico

“…Parece que los TUA coexisten con varias enfermedades psiquiátricas, particularmente trastornos afectivos, trastornos de ansiedad, y trastornos de personalidad (Anthenelli, 2012;Grant et al, 2004aGrant et al, , 2004bGrant et al, , 2015Hasin y Grant, 2015;Kessler et al, 1997;Klimkiewicz, Klimkiewicz, Jakubczyk, Kieres-Salomoński, y Wojnar, 2015;Mellos, Liappas, y Paparrigopoulos, 2010;Rosenberg et al, 1998). Se han propuesto varias hipótesis diferentes para explicar la comorbilidad entre diagnósticos psiquiátricos y TUA: automedicación, aliviar la disforia, factores de riesgo psicosociales, predisposición genética, o vulnerabilidad neurobiológica compartida (Buckley, 2006;Mueser, Drake, y Wallach, 1998).…”

“…Ese estudio no halló diferencias en la frecuencia de TUA en el espectro unipolar-bipolar, aunque el análisis no usó el cuestionario CAGE, sino los criterios diagnósticos de la Entrevista Clíni-ca Estructurada para los Trastornos del Eje I del DSM-IV. Otros autores han reportado tasas de prevalencia entre 10-60% de TUA a lo largo de la vida en pacientes con depresión unipolar (Klimkiewicz et al, 2015;Satre et al, 2008;Sullivan et al, 2005;Worthington et al, 1996). De acuerdo con nuestros resultados, se ha reportado una prevalencia de TUA entre 16,4-30% en pacientes con trastorno de per-sonalidad (Echeburúa, de Medina, y Aizpiri, 2005;Grant et al, 2004a;Klimkiewicz et al, 2015;Mellos et al, 2010).…”

“…En nuestra muestra, los pacientes con un trastorno de ansiedad obtuvieron un porcentaje más bajo de puntuaciones positivas en la CAGE (22,3%) en comparación con otros grupos de pacientes con diagnóstico psiquiátrico. La comorbilidad entre TUA y trastornos de ansiedad se ha descrito en un 7-18% de los pacientes con trastornos de ansiedad (Klimkiewicz et al, 2015;Vorspan et al, 2015). Un meta análisis reciente ha confirmado la asociación entre TUA y trastornos de ansiedad, con una RM de 1,636 para cualquier trastorno de ansiedad y abuso de alcohol, y una RM de 2,53 para la dependencia del alcohol (Lai, Cleary, Sitharthan, y Hunt, 2015).…”

Dyadic Adjustment Among Healthy Spouses of Bipolar I and Ii Disorder Patients

“…Some authors postulate that marital conflict affecting BD patients' relationships is so ubiquitous that it can act as an indicator of the presence of illness in one of the partner. What is more, it has been proven that there is a higher conflict level in these marriages/families than in others (Hoover & Fitzgerald 1981 Klimkiewicz et al 2015) which are another factors leading to escalation of the spousal burden and causing the deterioration in their relationship (Whisman 2007).…”

Personality disorders and the risk of violating legal norms – what we know about the complex nature of humans

“…Klimkiewicz, Kimkiewicz, Jakubczyk, Kieres-Solomoński, and Wojnar (2015) noted that some psychotic disorders in predisposed individuals support the development of addiction. These include dyssocial personality disorder, schizophrenia, bipolar affective disorder, anxiety with panic attacks, social phobia, posttraumatic stress syndrome, depression, and hyperactivity with attention deficit disorder.…”