Commentary on the study: impact of depressive symptoms on future alcohol use in patients with co-occurring bipolar disorder and alcohol dependence: a prospective analysis in an 8-week randomized controlled trial of acamprosate (Prisciandaro et al.)

Background: Comorbidity of alcohol abuse and dependence with bipolar disorders is high. The aim of this short commentary is to review a current study investigating the impact of depressive symptoms and craving on alcohol use in individuals with co-occurring bipolar disorder and alcohol dependence.

Methods: The strengths of Prisciandaro and colleagues' (2012) study are reviewed. The research group collected data as part of an 8-week, randomized, double-blind, placebo-controlled trial of acamprosate treatment in comorbid individuals.

Results: The importance of the study lies in highlighting the complex relationship between bipolar affective disorder symptoms, in particular depression, and alcohol use in a prospective design. It also overcomes several shortcomings of previous studies, since trajectories of both disorders within a short time frame of 1 week were hitherto rarely investigated.

Conclusions: While the current study is successfully shedding LIGHT on the relationship between depressive symptoms, craving, and alcohol use in comorbid individuals, future studies may also investigate the influence of rapid cycling, mixed states, and psychotic symptoms on alcohol consumption and vice versa. Further, other comorbid samples could be included like first episode versus subjects with multiple affective episodes or comorbidity in males versus females. This research may provide a better basis for future psychotherapy and pharmacotherapy or integrated treatment approaches in these comorbid and severely affected individuals.