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 illness. In view of lower prevalence of alcohol use disorders in some Asian groups, we attempted to investigate the alcohol problems among Chinese bipolar patients in Taiwan. Methods: The clinical data of bipolar patients (DSM-III-R) having been followed-up naturally for at least 15 years were obtained by a combination of chart reviews and interviews with patients and family members. Results: Based on a retrospective chart review of 158 patients, 8.2% of them were found to have alcohol problems. The lifetime prevalence of alcohol abuse was 6.9%, and of alcohol dependence 3.0% among 101 subjects accepting interview. According to the Global Assessment of Functioning Scale (APA, 1994) nearly one-third of them were clearly dysfunctional. Limitation: As subjects had a greater mean age, the age-related effects probably worsened the psychosocial outcome and reduced the incidence of new substance abuse. Conclusion: Chinese bipolar patients, despite a lower comorbidity of alcohol use disorders, do not have a more favorable long-term psychosocial outcome (marriage, work, and social adjustment) than Western patients.