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Classification of alcoholism with reference to comorbidity
B L Cook1, G Winokur, R C Fowler
1Department of Veterans Affairs Medical Center, Iowa City, IA.
Comprehensive Psychiatry
|May 1, 1994
Summary
This study explored alcoholism subtypes, finding that individuals with antisocial personality disorder exhibited more severe symptoms and behavioral discrepancies. These results highlight the heterogeneity within alcoholism, suggesting distinct patient subgroups require tailored approaches.
Area of Science:
- Psychiatry
- Addiction Medicine
- Clinical Psychology
Background:
- Current classification of alcoholism lacks granularity.
- Understanding subgroups within alcoholism is crucial for effective treatment.
- Antisocial personality disorder (ASPD) may define a distinct alcoholic profile.
Purpose of the Study:
- To investigate if ASPD and other primary psychiatric disorders identify subgroups of alcoholics.
- To determine if these subgroups exhibit differing characteristics.
- To compare alcohol-related symptoms and psychiatric signs across identified subgroups.
Main Methods:
- Alcoholic probands (n=224) were categorized into primary alcoholism (n=128), antisocial alcoholism (n=50), and secondary alcoholism (n=46).
- Groups were assessed for alcohol-related symptoms.
- Psychiatric signs and symptoms were evaluated across all groups.
Main Results:
- The antisocial alcoholic group presented as the most severe overall.
- Antisocial and primary alcoholic groups showed similarities, but antisocial group was more severe.
- Antisocial alcoholics displayed a dissociation between reported and observed behaviors.
Conclusions:
- Findings support the concept of heterogeneity within the alcoholism spectrum.
- Subgrouping alcoholics, particularly those with antisocial traits, is clinically relevant.
- Further longitudinal studies are needed to confirm if cross-sectional differences predict outcomes.