İki uçlu bozukluklu hastalarda alkol ve madde ekhastalığı biyolojik mi, kültürel mi?

İki uçlu bozukluklu hastalarda alkol ve madde bağımlılığı normalden yüksek bulunmuştur. Bu yükseklik, hastalığın biyolojik bir parçası olarak izah edilmektedir. İki uçlu bozukluklu hastalarda Obsesif Kompulsif Bozukluk (OKB) ekhastalık, Türkiye ve Amerika’da yaklaşık %10-20 ile benzerdir. Alkol ve madde ekhastalık ise Amerikan toplumundaki İki uçlu bozukluklu) hastalarda %30-50 oranında iken, Türkiye’de %3.2’dir. İki uçlu bozukluklu hastalardaki alkol madde ekhastalık yalnızca hastalığın biyolojik bir parçası olarak değil, hem biyolojik hem de kültürel parçası olarak anlaşılmalıdır.

Anahtar Kelimeler:

iki uçlu bozukluk, kültür, alkol, psikoaktif madde, eştanı

Comorbid diagnosis of alcohol and substance dependence in patients with bipolar disorder: is it biological or cultural?

Alcohol and substance dependence is more prevalent amongst patients with Bipolar Disorder than general population and this high rate of co-occurrence has been attributed to the underlying biology of Bipolar Disorder. Co-morbid diagnosis of Obsessive –Compulsive Disorder (OCD) in patients with Bipolar Disorder has similar prevalence rates of 10-20% both in the US and Turkey. On the other hand; whilst the co-occurrence of Bipolar Disorder with alcohol and substance dependence is 30-50% in the US, it is as low as 3.2% in Turkey. Therefore, this comorbidity should not be solely attributed to the biological process underlying Bipolar disorder and the role of social and cultural factors must also be taken into account.

Keywords:

bipolar Disorder, culture, alcohol, psychoactive substance, comorbidity,

PDF

___

Grant BF, Prevalence and correlates of alcohol use and DSM-IV alcohol dependence in the United States: results of the National Longitudinal Alcohol Epidemiologic Survey. J Stud Alcohol. 1997;58:464-73.
Regier DA, Farmer ME, Rea DS, Locke BZ, Keith SJ, Judd LL, Goodwin FK. Comorbidity of mental disorders with alcohol and other drug abuse: results from the Epidemiological Catchment Erea (ECA) study. JAMA. 1990;264: 2511-8.
Kessler R, McGonagle K, Zhao S, Nelson CB, Hughes M, Eshiemen S, Wittchen HU, S.L. McElroy, L.L. Altshuler, T. Suppes, P.E. Keck Jr., M.A. Frye, K.D. Denicoff, W.A. Nolen, R.W. Kupka, G.S. Leverich, J.R. Rochussen, A.J. Rush, R.M. Post. Axis I psychiatric comorbidity and its relationship to historical illness variables in 288 patients with bipolar disorder. American Journal of Psychiatry;2001;158:420–6.
Cassidy F, Ahearn EP, Carroll BJ. Substance abuse in bipolar disorder. Bipolar Disord 2001;3:181-8.
G.E. Murphy, R.D. Wetzel, E. Robins, L. McEvoy. Multiple risk factors predict suicide in alcoholism. Archives of General Psychiatry. 1992;49:459–
WHO, A summary of global status report on alcohol, Management of Substance Dependence Non-Communicable Diseases World Health Organization June 2001.
Tohen M, Greenfield SF, Weiss RD, Zarate CA Jr, Vagge LM. The effect of comorbid substance use disorders on the course of bipolar. Harv Rev Psychiatry 1998; 6:133-141.
Y.W. Chen, S.C. Dilsaver, Co-morbidity for obsessive-compulsive disorder in bipolar and unipolar disorders, Psychiatry Res. 1995;59:57–64.
Altındağ A, Yanik M, Nebioglu M. The comorbidity of anxiety disorders in bipolar I patients: prevalence and clinical correlates. Isr J Psychiatry Relat Sci 2006;43:10-5.
Akkaya C, Altın Murat, Kora Kaan, Karamustafalıoğlu N, Yaşan A, Tomruk N, Kurt E, Sociodemographic and clinical features of patients with bipolar I disorder in Turkey-HOME study, Bulletin of Clinical Psychopharmacology 2012;22:31-42.