Clinical relevance of the distinction between alcohol dependence with and without a physiological component

Marc A. Schuckit, Tom L. Smith, Jean Bernard Daeppen, Mimy Eng, T. K. Li, Victor M. Hesselbrock, John Nurnberger, Kathleen K. Bucholz

Research output: Contribution to journalArticle

82 Citations (Scopus)

Abstract

Objective: DSM-IV indicates that diagnoses of substance dependence should be further characterized with regard to the presence of a physiological component, defined by tolerance or withdrawal. This study evaluated the possible meaning of this distinction in alcohol-dependent men and women. Method: As part of the Collaborative Study on the Genetics of Alcoholism, structured interviews were carried out with 3,395 DSM-III-R- defined alcohol-dependent individuals divided into 2,949 subjects (86.9%) with evidence of tolerance and/or withdrawal (group 1), 51.3% of whom evidenced withdrawal symptoms, and 446 subjects (13.1%) without a physiological component (group 2). Data were evaluated to determine differences between the two groups. Results: Group 1 reported greater severity of alcohol dependence as demonstrated by a larger maximum number of drinks in 24 hours, more persons reporting hinges, more alcohol-related life problems, more relevant DSM-III-R criteria endorsed, more physiological complications, and more alcohol-related emotional/psychiatric symptoms such as depression and anxiety. Each of these severity indicators for problems in group 1 was significant in the presence of the others in a logistic regression, and similar items remained significant when tolerance alone, withdrawal alone, or their combination was used as the criterion for group 1 membership; however, for withdrawal a larger proportion of the variance was explained by the predictor variables. The regression results were independent of gender, proband status, and history of antisocial personality disorder. Conclusions: The results support the clinical relevance of distinguishing between alcohol-dependent patients with and without a physiological component. The data indicate a potential advantage to limiting that definition to withdrawal only.

Original languageEnglish (US)
Pages (from-to)733-740
Number of pages8
JournalAmerican Journal of Psychiatry
Volume155
Issue number6
StatePublished - 1998
Externally publishedYes

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Alcoholism
Alcohols
Diagnostic and Statistical Manual of Mental Disorders
Antisocial Personality Disorder
Substance Withdrawal Syndrome
Substance-Related Disorders
Psychiatry
Anxiety
Logistic Models
Interviews
Depression

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Schuckit, M. A., Smith, T. L., Daeppen, J. B., Eng, M., Li, T. K., Hesselbrock, V. M., ... Bucholz, K. K. (1998). Clinical relevance of the distinction between alcohol dependence with and without a physiological component. American Journal of Psychiatry, 155(6), 733-740.

Clinical relevance of the distinction between alcohol dependence with and without a physiological component. / Schuckit, Marc A.; Smith, Tom L.; Daeppen, Jean Bernard; Eng, Mimy; Li, T. K.; Hesselbrock, Victor M.; Nurnberger, John; Bucholz, Kathleen K.

In: American Journal of Psychiatry, Vol. 155, No. 6, 1998, p. 733-740.

Research output: Contribution to journalArticle

Schuckit, MA, Smith, TL, Daeppen, JB, Eng, M, Li, TK, Hesselbrock, VM, Nurnberger, J & Bucholz, KK 1998, 'Clinical relevance of the distinction between alcohol dependence with and without a physiological component', American Journal of Psychiatry, vol. 155, no. 6, pp. 733-740.
Schuckit MA, Smith TL, Daeppen JB, Eng M, Li TK, Hesselbrock VM et al. Clinical relevance of the distinction between alcohol dependence with and without a physiological component. American Journal of Psychiatry. 1998;155(6):733-740.
Schuckit, Marc A. ; Smith, Tom L. ; Daeppen, Jean Bernard ; Eng, Mimy ; Li, T. K. ; Hesselbrock, Victor M. ; Nurnberger, John ; Bucholz, Kathleen K. / Clinical relevance of the distinction between alcohol dependence with and without a physiological component. In: American Journal of Psychiatry. 1998 ; Vol. 155, No. 6. pp. 733-740.
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