Effect of alcohol use on the course of bipolar disorder: One-year follow-up study using the daily prospective Life Chart method

Objectives Relatively little is known about the temporal relationship between alcohol use and subsequent mood changes in patients with bipolar disorder, and the available findings are inconsistent. The present study was a fine-grained analysis of the temporal relationship between alcohol use and short-term mood-switching probabilities. Methods The study included 137 patients with bipolar disorder who performed daily self-ratings of their mood symptoms and the number of alcohol units consumed for a period of up to 52weeks by using the National Institute of Mental Health self-rated prospective Life Chart Method. At baseline, the Structured Clinical Interview for DSM-IV was administered and demographic, social, and clinical characteristics were obtained. Multi-state models were used to assess the impact of the number of alcoholic drinks on patients' transition through different states of mood (depression, euthymia, and mania). Results The effect of alcohol use on the change in mood states was limited. For women in a depressive state, higher alcohol use was associated with a shorter time before entering the euthymic state [hazard ratio (HR)=1.18, 95% confidence interval (CI): 1.03-1.36, p