Multidimensional alcoholism typologies: could they guide clinical practice? Results from a 3-month prospective study

Abstract

Our findings point to the need to differentiate multidimensional alcoholism subtypes before planning the clinical management of alcohol use disorders.

The role of affective temperament as a predictor of relapse in alcohol dependence

“…Higher scores on SADQ indicate a greater level of alcohol dependence. Previous studies have showed good psychometric properties in a sample of Portuguese alcohol‐dependent patients …”

“…Psychiatric disorders from the impulsive spectrum share similarities with cyclothymia features. The tendency to this alternating pattern of emotional highs and lows increases the likelihood to act impulsively, to use immature defence mechanisms (like acting out) and to have low self‐directedness, all of which are known predictors of abstinence violation . Patients with poor judgment about their own ability to reach goals and to deal with reality, in combination with emotional volatility, are particularly prone to experience craving and to act on craving rather than controlling it and therefore tend to relapse .…”

“…Those who remained sober during the follow‐up period were placed in the abstinence group. Those who had an episode of alcohol consumption or a ‘mini‐lapse’ without reinstatement of dependence symptoms were also placed in the abstinence group as their classification is subjective and their verification is often difficult in an outpatient setting …”

“…Clinical and socio‐demographic information was collected through a semi‐structured interview for alcohol‐dependent patients that also explores family history of alcoholism, age of alcohol use, abuse and dependence onset, patterns of alcohol consumptions, previous alcohol treatments and alcohol‐related problems. This instrument has been used in several other studies …”

“…In clinical setting, relapses are more frequent in some alcohol‐dependent phenotypes . A previous study using several AUD empirical typologies concluded that patients who presented prominent features related to impulsivity, antisocial behaviour, concomitant polydrug use and limited cognitive performance have a propensity to relapse . It is also known that patients who slip or relapse are more likely to meet the criteria for a DSM‐IV Axis II cluster B personality disorder .…”