Bipolar disorder (BD) and alcohol use disorders (AUDs) are usually comorbid, and both have been associated with significant neurocognitive impairment. Patients with the BD-AUD comorbidity (dual diagnosis) may have more severe neurocognitive deficits than those with a single diagnosis, but there is paucity of research in this area. To explore this hypothesis more thoroughly, we carried out a systematic literature review through January 2015. Defender Faith Philip Roth Pdf To Word. Eight studies have examined the effect of AUDs on the neurocognitive functioning of BD patients. Most studies found that BD patients with current or past history of comorbid AUDs show more severe impairments, especially in verbal memory and executive cognition, than their non-dual counterparts. Greater neurocognitive dysfunction is another facet of this severe comorbid presentation. Implications for clinical practice and research are discussed.

Specifically, the application of holistic approaches, such as clinical staging and systems biology, may open new avenues of discoveries related to the BD-AUD comorbidity. The bipolar—alcohol comorbidity Several epidemiological and clinical studies have consistently found high rates of comorbid AUD (i.e., alcohol abuse or dependence) among BD patients (Merikangas et al.,; Mitchell et al.,; Oquendo et al., ). Indeed, BD is the DSM Axis I disorder most strongly associated with AUDs (Regier et al.,; Kessler et al., ).

Draft guidance for industry, Food and Drug Administration staff, and clinical laboratories: FDA notification and medical device reporting for laboratory developed tests (LDTs). DeviceRegulationandGuidance/GuidanceDocuments/UCM416684.pdf (accessed March 3, 2015). Informat srl Via Alemanni 1 - 88040 Pianopoli (CZ) Tel. 0968.425805 - Fax 0968.425756 - E-mail: info@fiscal-focus.it P. Hd Video Downloader Android App. Mar 19, 2015. Quaderni di finanza. The impact of high-frequency trading on volatility. Evidence from the Italian market. 80 marzo 2015. Benos and Sagade (2012) focus on a sample of four stocks included in the FTSE. Using a direct approach, we focus on those market participants that can be defined as. World Development Report 2015: Mind and Mindset. Washington DC: World Bank, 2014. – World Health Organization (WHO). Global status report on road safety: time for action. Geneva: WHO, 2009. Available online: www.un.org/ar/roadsafety/pdf/roadsafetyreport.pdf. International Federation of Red Cross and.

In a recent meta-analysis, lifetime prevalence of AUDs affected approximately one third of BD patients, with higher rates in male (44%) than in female (22%) patients (Di Florio et al., ). Overall, patients with addictions are 5–6 times more likely to have a history of BD compared to the general population (Kessler et al., ). Research has identified three subgroups of patients, presenting with AUD first, BD first, and both simultaneously. BD preceded by addiction may represent a milder illness form (Pacchiarotti et al., ). Although the etiology of the BD-AUD comorbidity is poorly understood, several explanations have been put forward.

Both BD and AUD are complex-trait conditions with overlapping etiopathophysiological pathways at the genetic, neurochemical, neurophysiologic and neuroanatomic levels (Farren et al., ). Shared genetic basis could confer risk for both BD and AUD (Johnson et al., ). Interestingly, this common genetic vulnerability would not be entirely driven by confounders, such as liability for anxiety disorders (Carmiol et al., ). Moreover, comorbid alcohol and substance use may also be a coping strategy by which patients try to manage (e.g., by self-treatment) their mood symptoms (Bizzarri et al.,; Do and Mezuk, ).

BD and addictions may share common mechanisms, including high impulsivity, executive dysfunction, susceptibility to behavioral sensitization to stressors, as well as poor modulation of motivation and responses to rewarding stimuli (Swann,; Tolliver and Hartwell, ). Indeed, high trait impulsivity may mediate some severe manifestations of this comorbidity (Swann et al.,; Nery et al., ). At the clinical level, dual diagnosis seems to be mutually detrimental since addiction worsens the clinical presentation, course, prognosis and treatment of BD, and vice versa (Salloum and Thase, ).

Compared to BD patients without addictions, dually diagnosed patients have earlier age of onset, poor treatment adherence and treatment response, longer and more frequent mood episodes and hospitalizations, more mixed episodes and rapid cycling, more comorbid anxiety disorders and greater impulsivity, and higher rates of aggressive behavior and suicide attempts (Swann,; Tolliver and Hartwell,; Nery et al., ). Comorbid addictions worsen functioning in BD, sometimes to that of SZ patients (Jaworski et al., ).

Clearly, dual BD represents a prevalent, severe and difficult to treat subgroup of BD, but, surprisingly, little is known about its neurobiological and neurocognitive correlates (Nery et al., ). The neurocognitive dysfunction associated with alcohol use disorders Chronic alcoholism exerts harmful effects on brain health and cognition, including significantly decreased cortical thickness (Momenan et al., ).