RESUMO
Alcohol use is highly prevalent in patients with bipolar disorder (BD) and is associated with significant mortality and morbidity. The detrimental effects of each condition are compounded by the presence of the other. The objective of this study was to examine the impact of alcohol abuse and of alcohol dependence in BD in a Brazilian sample, as indicated by clinical severity, functional impairment, and quality of life (QOL). A cross-sectional survey of 186 bipolar outpatients were interviewed using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders-4th Edition. The primary outcome measures were functioning, as indicated by the Global Assessment of Functioning Scale scores and QOL, as indicated by the World Health Organization Quality of Life Instrument. Secondary outcomes were clinical severity features. Alcohol abuse and dependence were associated with male gender, lower education, earlier age of onset, psychosis within first episode, depressive symptoms, and worse functioning. In addition, the presence of alcohol abuse or dependence was associated with remarkably high rates of suicide attempt. Our findings suggest that the co-occurrence of alcohol abuse/dependence with BD increases the risk for suicide attempt, which may reflect in part the greater severity of symptoms and impaired functioning. This subgroup of bipolar patients requires a treatment tailored to address both conditions.
Assuntos
Alcoolismo/epidemiologia , Transtorno Bipolar/epidemiologia , Adulto , Transtornos de Ansiedade/epidemiologia , Brasil/epidemiologia , Comorbidade , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Tentativa de Suicídio/estatística & dados numéricosRESUMO
O suicídio é uma emergência médica presente na prática clínica, sendo importante e necessário que todos os médicos tenham conhecimentos básicos sobre o tema. Os autores revisam a literatura médica com o objetivo de ampliar a compreensão acerca das causas e fatores de risco do suicídio, abrangendo fatores genéticos, ambientais, sociais, epidemiológicos e neurológicos. Trata também do manejo e das atitudes contratransferenciais do médico em relação a tal paciente
