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J Affect Disord. 2008 Mar;106(3):265-72. Epub 2007 Aug 16.

Treatment response of bipolar and unipolar alcoholics to an inpatient dual diagnosis program.

Author information

1
Trinity College Dublin, Department of Psychiatry, St. Patrick's Hospital, James Street, Dublin 8, Ireland. cfarren@stpatsmail.com

Abstract

BACKGROUND:

Depressed and bipolar alcoholics represent a significant affective subgroup that has a poorer prognosis than either diagnosis alone. To date few systematic treatment programs have been developed to treat dual diagnosis.

METHODS:

An inpatient treatment program was developed at St Patrick's Hospital Dublin to treat dual diagnosis clients with alcohol dependence and either unipolar or bipolar affective disorder. Clients (N=232) were assessed for depression, anxiety, elation, cravings, drink and drug intake on admission, discharge, 3 and 6 months post-discharge from the program.

RESULTS:

In the overall group there was a reduction in number of drinking days and units per drinking day over the study (p<.01). There was a 71.8% complete abstinent rate at 3 months and 55.8% at 6 months in the depression group, non-significantly greater than for the bipolar group at 64.7% and 54.1% respectively. Gamma GT, MCV and craving scores were significantly reduced over time (p<.01). Mania, depression and anxiety inventory scores fell over time in both groups (p<.01). 15-21-year olds were more severely anxious, had higher illicit drug use, and were more likely to relapse to drug use than older clients. Bipolar 1 clients were significantly more likely than bipolar 2 clients to be on mood stabilisers at all follow-up stages (p<.001).

LIMITATIONS:

No control group was used.

CONCLUSIONS:

There is evidence for efficacy of a specifically designed dual diagnosis inpatient treatment program as both depressed and bipolar alcoholics had significant reductions in all measurements of mood, craving, and alcohol/drug consumption by self report and biological markers, suggesting both diagnoses can be effectively treated together.

PMID:
17707085
DOI:
10.1016/j.jad.2007.07.006
[Indexed for MEDLINE]
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