Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA.
Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, NY, USA.
J Affect Disord. 2023 Mar 15;325:329-336. doi: 10.1016/j.jad.2022.12.140. Epub 2022 Dec 30.
Alcohol use disorder (AUD) is exceedingly common among individuals with bipolar disorder and schizophrenia. However, studies on alcohol use in psychiatric illness rely largely on population surveys with limited representation of severe mental illness (SMI); schizophrenia and bipolar disorder.
Using data from the Genomic Psychiatry Cohort (GPC) (Pato MT, 2013), associations of bipolar disorder and schizophrenia with alcohol use problems were examined in a diverse US based sample, considering the influence of self-described race (African Ancestry (AA), European Ancestry (EA), or Latinx Ancestry (LA)), sex, and tobacco use. Participants answered alcohol use problem items derived from the CAGE instrument, yielding a summed "probable" alcohol use disorder (pAUD) risk score.
This study included 1952 individuals with bipolar disorder with psychosis (BDwP), 409 with bipolar disorder without psychosis (BD), 9218 with schizophrenia (SCZ), and 10,416 unaffected individuals. We found that SMI (BDwP, BD, SCZ) was associated with elevated AUD risk scores (B = 0.223, p < 0.001), an association which was strongest in females, particularly those of AA and LA, and in tobacco users. Schizophrenia was associated with the greatest increase in pAUD score (B = 0.141, p < 0.001). pAUD risk scores were increased among participants with bipolar disorder, with greater increases in BDwP (B = 0.125, p < 0.001) than in BD without psychosis (B = 0.027, p < 0.001).
Limitations include reliance on self-report data, screening items for AUD, voluntary recruitment bias, and differences in race/sex distribution between groups, which were statistically adjusted for in analytic models.
SMI is associated with risk for AUD, particularly among females from racial minority groups, smokers, and those with psychotic disorders.
酒精使用障碍（AUD）在双相情感障碍和精神分裂症患者中极为常见。然而，精神疾病中酒精使用的研究主要依赖于代表性有限的人群调查，无法涵盖严重精神疾病（SMI）；包括精神分裂症和双相情感障碍。
利用来自基因组精神病学队列（GPC）的数据（Pato MT，2013 年），在一个多元化的美国样本中，考虑到自我描述的种族（非裔美国人（AA）、欧裔美国人（EA）或拉丁裔美国人（LA））、性别和烟草使用的影响，研究了双相情感障碍和精神分裂症与酒精使用问题的关联。参与者回答了源自 CAGE 工具的酒精使用问题项目，得出了一个总和“可能”的酒精使用障碍（pAUD）风险评分。
这项研究包括 1952 名有精神病性症状的双相情感障碍患者（BDwP）、409 名无精神病性症状的双相情感障碍患者（BD）、9218 名精神分裂症患者（SCZ）和 10416 名未受影响的个体。我们发现，SMI（BDwP、BD、SCZ）与 AUD 风险评分升高相关（B=0.223，p<0.001），这种关联在女性中最强，尤其是非裔和拉丁裔女性，以及烟草使用者中。精神分裂症与 pAUD 评分的最大升高相关（B=0.141，p<0.001）。与未受影响的个体相比，双相情感障碍患者的 pAUD 风险评分升高，其中精神病性症状的双相情感障碍患者（BDwP）的增加幅度更大（B=0.125，p<0.001），而非精神病性症状的双相情感障碍患者（BD）的增加幅度较小（B=0.027，p<0.001）。
限制包括依赖于自我报告数据、酒精使用障碍筛查项目、自愿性招募偏差以及各组之间的种族/性别分布差异，这些差异在分析模型中进行了统计学调整。
SMI 与 AUD 风险相关，尤其是在来自少数族裔群体的女性、吸烟者和患有精神病性障碍的人群中。
