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Self-report reasons for alcohol use in bipolar disorders: why drink despite the potential risks?

High rates of alcohol use and misuse are commonly reported for bipolar disorder (BD) and in many cases, these impact detrimentally on the course and treatment of the disorder. Therefore, knowing the reasons individuals with a diagnosis of BD give for drinking alcohol is essential for understanding this association and for treatment. This paper aimed to systematically review the literature relating to self-reported reasons and motives for alcohol use in BD. By using internet-based search engines such as PsycINFO and Medline, six relevant studies were identified and then quality-assessed using a set of criteria specifically developed for this review. Overall, the findings supported the intuitive notion that individuals with a diagnosis of BD use alcohol to relieve distressing mood states. However, there was evidence of other mood-related and mood--unrelated reasons--e.g., drinking to enhance euphoric mood or to be sociable. These findings are discussed in relation to the self-medication hypothesis and cognitive motivational models of alcohol use developed in the general population. The quality assessment also revealed several limitations including diagnostically heterogeneous samples and inconsistencies in measurement between studies, and recommendations for addressing these limitations are given.