Gender differences in outcome at 2-year follow-up of treated bipolar and depressed alcoholics.

OBJECTIVE

Alcohol dependence and affective disorders are significant health problems, and their co-occurrence is mutually detrimental. There are few long-term studies on the impact of treatment on the prognosis of these comorbid disorders. We wished to study if the impact of effective inpatient integrated treatment for these co-occurring disorders was maintained 2 years after discharge from the hospital.

METHOD

A total of 189 patients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for alcohol dependence and either bipolar disorder or depression were recruited, assessed, and assigned to an inpatient treatment unit. Following intensive integrated treatment that was designed to integrate psychotherapy with pharmacotherapy, affective disorder with substance use disorder treatment, and inpatient with outpatient therapy, this population was followed for 2 years after discharge.

RESULTS

Treatment improvements above baseline that were achieved over the course of the 4-week intensive inpatient treatment were essentially maintained over a 2-year outpatient period. Depression, elation, anxiety, and craving scores all fell, as did all drinking outcome measures in both depressed and bipolar alcohol-dependent groups. Findings suggested that women with a diagnosis of bipolar disorder reported higher levels of depression and anxiety symptoms than male bipolar patients at 2-year follow-up. More women than men remained abstinent at 2 years after treatment, with this difference mainly in the depressed sample.

CONCLUSIONS

Comorbid bipolar alcoholics and depressed alcoholics can be treated successfully together on an integrated inpatient treatment program, and the benefits can last for up to 2 years. There also appeared to be significant gender differences in treatment outcomes.