The effects of ethnic, social and cultural factors on axis I comorbidity of bipolar disorder: Results from the clinical setting in Korea

Objective: Ethnic, social and cultural factors contribute to axis I comorbid conditions in bipolar disorder (BPD). Korea has strict laws against illicit drugs and a relatively permissive prevailing attitude toward alcohol. The present study aimed to explore the lifetime axis I comorbidity rate in patients with BPD in Korea. Methods: Clinically stable patients with bipolar l (n=222) and bipolar II (n=194) disorders were recruited from four tertiary medical centers in Korea. The subjects diagnoses and axis l comorbid conditions were evaluated using the Structured Clinical Interview for DSM-IV Axis l Disorders (SOD) and the Korean version of the Diagnostic Interview for Genetic Studies (K-DIGS). The lifetime prevalence of anxiety disorders, substance use disorders and eating disorders was explored. The prevalence of these axis l comorbid conditions was compared with data from prior studies in other countries and to data concerning the general Korean population. Results: A total of 45.1% of all subjects had at least one axis I comorbid condition. Anxiety disorders (30.2%) were the most common comorbidity, followed by alcohol use disorders (16.8%). Males with BPD showed a higher rate of alcohol dependence compared to the general male population and females with BPD showed a greater risk of having alcohol use disorder compared to the general female population. The rate of drug use disorder was extremely low (1.7%), and only one subject had an illicit-drug-related problem. Limitation: Cross-sectional studies. Conclusion: Comorbid conditions of Korean patients with BPD showed a distinct pattern, which is associated with the ethnic, social and cultural characteristics in Korea. (C) 2014 Elsevier B.V. All rights reserved.