PhD ceremony Mr. J. van Zaane: Bipolar disorder and alcohol. Double trouble or just co-occurrence?

PhD ceremony: Mr. J. van Zaane, 12.45 uur, Academiegebouw, Broerstraat 5, Groningen

Dissertation: Bipolar disorder and alcohol. Double trouble or just co-occurrence?

Promotor(s): prof. W.A. Nolen, prof. W. van den Brink

Faculty: Medical Sciences

Bipolar (manic-depressive) disorders (BD) and substance use disorders (SUD) are “co-travelers”. About 50% of the patients with BD have a comorbid SUD during live.

This thesis addresses two important questions. The first question refers to the problem of early detection of BD in patients who seek treatment in addiction centers. The validity of the screening instrument for BD, the Mood Disorder Questionnaire (MDQ), was tested in this population. The results showed that the MDQ is not a suitable instrument to rule in BD in a treatment seeking addiction population. Many patients who tested positive on the MDQ had another diagnosis than BD, such as borderline personality disorder. In contrast, the MDQ could be used to rule out BD in patients who seek treatment in addiction centers.

The second question in this thesis addresses the effect of moderate (social) use of alcohol on the course and outcome in patients with BD. This issue has never been thoroughly examined. The results of our study showed that moderate use of alcohol did not have a negative effect (more and longer episodes, faster recurrence) on the course and outcome. However, patients with excessive use of alcohol also showed no negative effect on the course and outcome. Our results are not in line with other studies that showed a lot of negative effects when BD patients used excessive alcohol. Our main explanation is that our patients, in contrast to the patients of the other studies, were very adherent to their medication.