The course of bipolar disorder as a function of the presence and sequence of onset of comorbid alcohol use disorders in outpatients attending the Fondamental Advanced Centres of Expertise

Icick, Romain; Gard, Sébastien; M’Baïlara, Katia; Biseul, Isabelle; Samalin, Ludovic; Brousse, Georges; Flaudias, Valentin; Llorca, Pierre‐Michel; Loftus, J.; Cussac, I.; Aubin, V.; Schwan, Raymund; Roux, Paul; Polosan, Mircea; Courtet, Philippe; Olié, Émilie; Henry, Chantal; Mazer, N.R Chamoles de; Haffen, Emmanuel; Étain, Bruno; Leboyer, Marion; Bellivier, Frank; Belzeaux, Raoul; Godin, O.; Guillaume, Sébastien

doi:10.1016/j.jad.2021.03.041

Cited by 5 publications

(4 citation statements)

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“…This study found that those diagnosed with AH and B1D were more likely to be female despite prior literature suggesting that men are at higher risk of both AUD and B1D [ 15 ]. This may be a consequence of the sex differences in the amount and frequency of alcohol consumption leading to liver disease.…”

Section: Discussionmentioning

confidence: 57%

Outcomes of Hospitalized Acute Alcoholic Hepatitis (AH) in Patients With Bipolar 1 Disorder (B1D)

Kaye¹,

Patel²,

Meyers³

et al. 2022

Cureus

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Introduction: Alcoholic hepatitis (AH) is a common cause of hospital admissions and is associated with a high mortality rate. AH occurs frequently in patients with heavy alcohol use. Alcohol use disorder (AUD) commonly presents with comorbid psychiatric disorders such as bipolar disorder. Bipolar disorder patients are also known to be at an increased risk for chronic liver diseases. Bipolar 1 disorder (B1D) is often considered the most severe presentation among different types of bipolar disorder. This study assesses the clinical outcomes of patients admitted for AH with concomitant B1D. Methods: Adult patients with AH were identified within the 2014 National Inpatient Sample (NIS) database. International Classification of Diseases, Ninth Edition Revision, Clinical Modification (ICD-9 CM) codes were used to select for all of the diagnoses for this study. AH patients were subdivided into those with and without B1D. The outcomes of interest were sepsis, hepatic encephalopathy, acute respiratory failure, acute kidney injury, ischemic stroke, hepatic failure, coagulopathy, and inpatient mortality. A multivariate logistic regression analysis was performed to explore whether B1D is an independent predictor for the outcomes. Results: Among 4,453 patients with AH identified, 166 patients also had B1D. AH patients with comorbid B1D were seen to be younger (42.9 years old vs. 46.2 years old, p < 0.05) and more commonly female (55.4% vs. 36.5%, p < 0.05). The B1D subgroup of AH patients were found to less likely develop acute hepatic failure (adjusted odds ratio (aOR) 0.13, 95% confidence interval (CI): 0.02-0.97, p < 0.05). The adjusted odds ratios for the remaining outcomes were not statistically significant. Conclusions: Our study indicates that B1D may be an independent protective factor against acute hepatic failure in patients hospitalized with AH. This finding can be explained by frequent laboratory monitoring and psychiatric assessments performed by psychiatrists treating B1D patients, as well as the impact B1D has on cortisol release induced by hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis.

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Section: Discussionmentioning

confidence: 57%

Outcomes of Hospitalized Acute Alcoholic Hepatitis (AH) in Patients With Bipolar 1 Disorder (B1D)

Kaye¹,

Patel²,

Meyers³

et al. 2022

Cureus

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“…Previous studies on the FACE-BD cohort and SUDs focused on other SUDs (e.g., alcohol use disorders 33 ) or on the presence of any SUD and specific characteristics of BD (e.g., suicidal behavior). 34,35 In the current study, we focused specifically on lifetime tobacco smoking status, analyzing separately former smokers from the two other groups and its association with the characteristics of BD.…”

Section: Discussionmentioning

confidence: 99%

Physical and mental health status of former smokers and non‐smokers patients with bipolar disorder

Nobile,

Godin,

Gard

et al. 2023

Acta Psychiatr Scand

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Objectives Up to 70% individuals with bipolar disorder (BD) are lifetime tobacco smokers, a major modifiable risk factor for morbidity. However, quitting smoking is rarely proposed to individuals with BD, mainly because of fear of unfavorable metabolic or psychiatric changes. Evaluating the physical and mental impact of tobacco cessation is primordial. The aim of this study was to characterize the psychiatric and nonpsychiatric correlates of tobacco smoking status (never‐ vs. current vs. former smokers) in individuals with BD. Methods 3860 individuals with ascertained BD recruited in the network of Fondamental expert centers for BD between 2009 and 2020 were categorized into current, former, and never tobacco smokers. We compared the sociodemographic and clinical characteristics assessed by standard instruments (e.g., BD type, current symptoms load, and non‐psychiatric morbidity—including anthropometric and biological data) of the three groups using multinomial regression logistic models. Corrections for multiple testing were applied. Results Current smokers had higher depression, anxiety, and impulsivity levels than former and never‐smokers, and also higher risk of comorbid substance use disorders with a gradient from never to former to current smokers—suggesting shared liability. Current smokers were at higher risk to have a metabolic syndrome than never‐smokers, although this was only evidenced in cases, who were not using antipsychotics. Conclusions Tobacco smoking was associated with high morbidity level. Strikingly, as in the general population, quitting smoking seemed associated with their return to the never‐smokers' levels. Our findings strongly highlight the need to spread strategies to treat tobacco addiction in the BD population.

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“…Furthermore, alcohol use can destabilize the course of an underlying mental illness. For example, alcohol use in bipolar patients leads to more mood swings (46), more rapid cycling (46)(47)(48), and a higher suicidal risk (47)(48)(49)(50). In depression, alcohol use is associated with a higher level of depressive symptoms (51) and a more altered quality of life (52).…”

Section: Discussionmentioning

confidence: 99%

Could reasons for admission help to screen unhealthy alcohol use in emergency departments? A multicenter French study

Chabert,

Lambert,

Cabé

et al. 2023

Front. Psychiatry

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BackgroundMany patients admitted to general emergency departments (EDs) have a pattern of drinking that could lead to future alcohol-related complications. However, it is often difficult to screen these patients in the context of emergency. The aim of this study is to analyze whether reasons for admission could help to screen patients who have an unhealthy alcohol use.MethodPatients were recruited among six public hospital ED in France, between 2012 and 2014. During a one-month period in each hospital, anonymous questionnaires including sociodemographic questions, AUDIT-C and RAPS4-QF were administered to each patients visiting the ED. The reason for admission of each patient was noted at the end of their questionnaire by the ED practitioner.ResultsTen thousand Four hundred twenty-one patients were included in the analysis. Patients who came to the ED for injuries and mental disorders were more likely to report unhealthy alcohol use than non-harmful use or no use. Among male patients under 65 years old admitted to the ED for a mental disorder, 24.2% drank more than four drinks (40 g ethanol) in typical day at least four time a week in the last 12 months. Among these patients, 79.7% reported daily or almost daily heavy episodic drinking (HED, 60 g ethanol), and all were positive on the RAPS4-QF.ConclusionThis study highlights that unhealthy alcohol use is frequent among ED patients and particularly among those who come for injuries or mental disorders. Men under 65 years old with a mental disorder require special attention because of their increased prevalence of daily or almost daily HED.

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The course of bipolar disorder as a function of the presence and sequence of onset of comorbid alcohol use disorders in outpatients attending the Fondamental Advanced Centres of Expertise

Cited by 5 publications

References 44 publications

Outcomes of Hospitalized Acute Alcoholic Hepatitis (AH) in Patients With Bipolar 1 Disorder (B1D)

Outcomes of Hospitalized Acute Alcoholic Hepatitis (AH) in Patients With Bipolar 1 Disorder (B1D)

Physical and mental health status of former smokers and non‐smokers patients with bipolar disorder

Could reasons for admission help to screen unhealthy alcohol use in emergency departments? A multicenter French study

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