The Collaborative Study on the Genetics of Alcoholism (COGA) is a family pedigree investigation which enrolled treatment-seeking alcohol-dependent probands who initially met the DSM-IV for alcohol dependence [33 ]. Six medical centers in the USA recruited the initial probands plus first-degree family members. The only exclusion criteria include life-threatening medical disorders, repeated intravenous drug use, and an inability to speak English. Written informed consent to participate in the study was obtained from all subjects. Participants and their relatives were interviewed at baseline using the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA), which focuses on demography, substance use patterns, and the assessment of 17 axis I DSM-IV diagnoses, as well as characteristics of bipolar disorder [16 (link),34 ].
While the SSAGA was developed prior to the publication of the DSM-IV criteria, all criteria symptoms for the DSM-IV diagnosis were assessed ages of onset and remission of symptoms [35 (link)]. Only the original probands or comparison subjects, their first-degree relatives, and offspring aged ≤20 years in the participating families were eligible for follow-up. Of all eligible subjects, the follow-up rate was 60% in probands, 65% in family members, and 78% in controls [35 (link)].
The interview also assessed past episodes of affective disorders, including depressive and manic episodes and the characteristics of the most severe episode. To receive a DSM-IV bipolar I disorder diagnosis, subjects had to report a lifetime diagnosis of both major depression and mania or any lifetime diagnosis of a manic episode. Individuals who had at least one major depression and hypomanic episode were considered to have bipolar II disorder.
N = 180 subjects with bipolar I or II disorder were identified. Of these n = 65 (36.1%) had an additional diagnosis of DSM IV CUD (cannabis dependence and cannabis abuse, CUD in 23 of 77 (29.8%) individuals, in bipolar II subjects and 40.8% (42 of 103 individuals in bipolar I subjects). Any CUDs (dependence and abuse) was found in 36.1% of bipolar I and II individuals.
Subjects with a bipolar II disorder without comorbid CUD but abstinent or with social CU were included into group 1 (n = 54) while group 2 (n = 23) consists of individuals with comorbid bipolar II and CUD diagnoses. Group 3 included subjects with a bipolar I diagnosis without CUD (n = 61) but either abstinence or social CU and group 4 were bipolar I subjects with a comorbid CUD (n = 42).
The probands and appropriate relatives were re-assessed at a mean of 5.72 years (±1.1 years) after the initial interview.
While the SSAGA was developed prior to the publication of the DSM-IV criteria, all criteria symptoms for the DSM-IV diagnosis were assessed ages of onset and remission of symptoms [35 (link)]. Only the original probands or comparison subjects, their first-degree relatives, and offspring aged ≤20 years in the participating families were eligible for follow-up. Of all eligible subjects, the follow-up rate was 60% in probands, 65% in family members, and 78% in controls [35 (link)].
The interview also assessed past episodes of affective disorders, including depressive and manic episodes and the characteristics of the most severe episode. To receive a DSM-IV bipolar I disorder diagnosis, subjects had to report a lifetime diagnosis of both major depression and mania or any lifetime diagnosis of a manic episode. Individuals who had at least one major depression and hypomanic episode were considered to have bipolar II disorder.
N = 180 subjects with bipolar I or II disorder were identified. Of these n = 65 (36.1%) had an additional diagnosis of DSM IV CUD (cannabis dependence and cannabis abuse, CUD in 23 of 77 (29.8%) individuals, in bipolar II subjects and 40.8% (42 of 103 individuals in bipolar I subjects). Any CUDs (dependence and abuse) was found in 36.1% of bipolar I and II individuals.
Subjects with a bipolar II disorder without comorbid CUD but abstinent or with social CU were included into group 1 (n = 54) while group 2 (n = 23) consists of individuals with comorbid bipolar II and CUD diagnoses. Group 3 included subjects with a bipolar I diagnosis without CUD (n = 61) but either abstinence or social CU and group 4 were bipolar I subjects with a comorbid CUD (n = 42).
The probands and appropriate relatives were re-assessed at a mean of 5.72 years (±1.1 years) after the initial interview.
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