Differential Impact of Depressive and Manic Mood States on Alcohol Craving in Comorbid Bipolar Alcoholism: Preliminary Findings

Objectives: To examine the differential impact of depressive and manic mood states on alcohol craving in patients with bipolar disorder and comorbid alcoholism. Materials and Methods: Forty-four men and women, aged 18 to 65 years, with DSM-IV-TR comorbid diagnoses of bipolar I disorder and alcohol dependence were assessed over a 3-month period to examine the extent to which their depressive and manic symptoms were associated with alcohol cravings (ie, desire to use and not to use alcohol) at each assessment point, controlling for age, ethnicity, socioeconomic status, baseline alcohol use, and number of assessments. Results: Both manic and depressive symptoms were associated with greater desire to use alcohol. Only depressive symptomatology was associated with reduced desire not to use alcohol, and desire not to use alcohol declined over the course of the 3-month treatment period. Conclusions: Whereas enhanced desire to drink alcohol may be a conditioned reaction to both manic and depressed mood states, desire not to drink alcohol may be more of an indicator of treatment motivation, which is negatively affected by depressed mood. Depressive symptoms may warrant prioritization and aggressive targeting early in treatment given that desire to refrain from alcohol use was only influenced by depressive symptoms and declined over the course of treatment.