[Alcoholism: value of a search for familial antecedents]

Alcoholism is a complex disorder, with clinical and etiological heterogeneity. The clinical symptoms used for the diagnostic of alcoholism are based on worldwild standard criteria, such as DSM (American Psychiatric Association) or ICD (World Health Organisation). Good agreement between clinicians for the diagnostic of alcoholism can be obtained with these classifications. The diagnostic of alcoholism with such international criteria is mainly based on the cognitive and behavior consequences of alcohol consumption. In order to cope with the heterogeneity of alcoholism, one should analyse the different aspects of alcoholism pathogenesis. One important aspect is its high frequency within some families, as many studies show a direct correlation between the risk for alcoholism and familial frequency of alcoholism. More recent studies tried to detect which clinical aspects of alcoholism are more frequently observed in alcoholic patients with a positive familial history. Those studies also analysed the impact of a familial history of co-morbid psychiatric disorders on the general risk for alcoholism and the specific risk for alcoholism and co-morbid psychiatric disorders. Most clinicians interested in alcoholism look for familial history of alcoholism or psychiatric disorders, but this information is frequently incomplete and partially used. The research on familial history of alcoholism is nevertheless facilitated, and more valid, with the recent clinical tools such as standard clinical questionnaires. The detection of a familial history can be in many aspects useful for establishing clinical subtypes, predicting specific (psychiatric, social or medical) complications, or helping to find the most relevant treatment modality.