Abstract

Objective: It is well-established that Bipolar Disorder (BD) has comorbidity with Alcohol Use Disorder (AUD) and could present the same symptoms of an underlying diagnosis of BD, therefore delaying the proper relevant treatment. Recent studies show the occurrence of alterations in the circulating levels of inflammatory mediators in patients dealing with AUD as well as those with BD. The objective of this study is to get an assessment of whether patients with AUD and BD comorbidity [BD(+)] would present different ratios of the Complete Blood Count (CBC) in comparison with patients with AUD but without a BD comorbidity [BD(−)]. Methods: This is a retrospective study, conducted through a selection of patients files who were admitted to the psychiatric department at Hôtel-Dieu de France University Hospital in Beirut, Lebanon, between January of the year 2016 and May of the year 2021. Overall, 83 files of patients dealing with AUD were included in this study. Results: Patients with BD(+) showed a higher Eosinophils to Lymphocytes Ratio (ELR) in comparison to those with BD(−). The Receiver Operation Characteristic (ROC) analysis had an area under the curve at 0.719 with a p = .001. The cutoff value of ELR that best differentiates BD(−) from BD(+) was 0.087 (Sensitivity = 81.3%; Specificity = 63.6%). The logistic regression analysis showed that an ELR superior to 0.087 presented a statistically significant difference, exposing patients belonging to the BD(+) group (OR = 11.66; p < .001). Conclusions: Our data suggest that ELR may be a valuable, reproducible, easily accessible, and cost-effective inflammatory marker, pointing at the presence of a BD comorbidity with AUD.

摘要

目的：众所周知，双相情感障碍 (BD) 与酒精使用障碍 (AUD) 共病，并且可能出现与 BD 的潜在诊断相同的症状，因此延迟了适当的相关治疗。最近的研究表明，在处理 AUD 和 BD 的患者中，炎症介质的循环水平发生了变化。本研究的目的是评估患有 AUD 和 BD 合并症的患者 [BD(+)] 与患有 AUD 但没有 BD 合并症的患者相比，是否会出现不同的全血细胞计数 (CBC) 比率 [BD( −)]。方法：这是一项回顾性研究，通过选择在 2016 年 1 月至 2021 年 5 月期间入住黎巴嫩贝鲁特法兰西大学医院精神病科的患者档案进行。总共有 83 个档案的患者处理 AUD 被包括在这项研究中。结果：与 BD(-) 患者相比，BD(+) 患者的嗜酸性粒细胞与淋巴细胞比率 (ELR) 更高。接受者操作特征 (ROC) 分析的曲线下面积为 0.719，p = .001。最能区分 BD(-) 和 BD(+) 的 ELR 截止值为 0.087（灵敏度 = 81.3%；特异性 = 63.6%）。逻辑回归分析表明，ELR 优于 0.087 具有统计学意义的差异，表明属于 BD(+) 组的患者（OR  = 11.66；p  < .001）。结论：我们的数据表明，ELR 可能是一种有价值的、可重复的、易于获取且具有成本效益的炎症标志物，表明存在 BD 与 AUD 的共病。