Wednesday, February 24, 2010

More debunking of easy assumptions

Here's a recent new item from Reuters Health. This among many similar studies shows how easy it is to assume certain "obvious" truths, when in fact there is little or no evidence for them. Professionals, families and patients often look to drug or alcohol use as a factor to explain things for which their may be no easy explanation, and those assumptions are seldom challenged. 


MW



Drinking may not worsen bipolar symptoms

2010-02-18 (Reuters Health)

By Joene Hendry

NEW YORK (Reuters Health) - Among people with bipolar disorder who strictly followed their medication plan, drinking alcohol did not appear to worsen their mood symptoms, hint findings of a small study from the Netherlands.

Bipolar disorder can cause extreme mood swings that require medication to control, and among those with the disease about half abuse alcohol and other drugs, Dr. Jan van Zaane, at University Medical Center Amsterdam, and colleagues note in the Journal of Clinical Psychiatry.

Other studies in patients with bipolar disorder have looked at substance abuse overall rather than just drinking.

To better understand specific effects from alcohol, van Zaane's team examined daily mood symptoms and alcohol intake over one year in 137 community living men and women with bipolar disorder but no other serious physical illness.

The study group was 23 to 68 years old. About half were women and about half lived with a partner and held a job.

The investigators describe 44 as "incidental" or non-drinkers, and 49 as moderate drinkers (21 and 14 or fewer drinks per week for men and women, respectively). The remaining 44 reported drinking more than moderate amounts.

A total of 104 kept diaries for the entire year. About half who stopped said they tired of the daily records and monthly monitoring required for study participation, while others did so due to worsening bipolar disease, alcohol dependence, and other reasons.

Still, all 137 participants kept daily mood diaries for at least two months, providing investigators with 44,808 days of mood data (about 327 days per participant).

The researchers were surprised to find the group of heavy drinkers did not have greater numbers of depressed days, number or severity of mood swings, or any other bipolar disorder symptom than the occasional or moderate drinkers.

More than 90 percent of the current participants reported taking prescribed bipolar disorder medication as directed. This, and the monthly clinical assessments required for participation in this study, likely partially explain the current findings, the researchers note.

However, this study compared groups, not individual patients, who should each monitor, with their doctor, how daily drinking affects bipolar mood symptoms, van Zaane said in an email to Reuters Health.

The investigators also call for confirmation of the current findings in further long-term evaluations of larger groups of patients with bipolar disorder.

SOURCE: Journal of Clinical Psychiatry, published online January 26, 2010.

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