Are there empirically supported and clinically useful subtypes of alcohol dependence?

Abstract

Even though the longitudinal outcomes of few empirically derived subtypes have been examined, alcoholism typologies remain a viable and potentially valuable tool for investigating etiological pathways, the effectiveness of treatments and the long-term course of alcohol use disorders.

Aplicabilidade da classificação de alcoolismo tipo A/tipo B

“…O consumo disfuncional de outras substâncias psicoativas é comumente relacionado ao subtipo que apresenta características clínicas mais graves [2][3][4]6,9,[15][16][17][18] . Similarmente, este estudo também identificou que o subtipo +G teria maior tendência ao uso disfuncional de outras substâncias psicoativas, da mesma forma que a maior probabilidade, já referida acima, de ter feito uso de benzodiazepínicos -um achado que deve ser levado em conta pelos profissionais responsáveis pela assistência médica a esses sujeitos.…”

Fatores associados à adesão a um programa de tratamento de alcoolistas

“…Ainda que diferentes estudos tenham demonstrado que a maior parte das pessoas com dependência de álcool apresentaria alguma comorbidade psiquiátrica associada, costuma-se enfatizar o elevado percentual de sujeitos com transtorno de personalidade anti-social (TPAS) nas amostras estudadas. Muito embora se acentue a relevância dos TPAS na abordagem do alcoolismo -associando-os a maior gravidade dos problemas relacionados ao álcool e piores resultados do tratamento [25][26][27][28] -, neste estudo, 52,6% dos pacientes tiveram registro de alguma comorbidade psiquiátrica e apenas um sujeito recebeu o diagnóstico de TPAS.…”

Are the binary typology models of alcoholism valid in polydrug abusers ?

“…All subjects then completed a psychometric battery and were evaluated in a face-to-face interview and asked directly about the items that comprise the operationalized criteria described by each alcoholism typology. 5 All investigators (psychiatrist and clinical psychologist) that performed the subtyping procedure had the necessary clinical skills to assess patients with addiction and scientific knowledge to manage the principles of each classification system (for more information, see Pombo & Lesch). 22 To accurately identify drug consumption in our sample, all patients underwent urine testing for the presence of opiates (heroin), cocaine, and cannabis (tetrahydrocannabinoids) metabolites.…”

“…Substance abuse typologies are used to diagnose addiction disorders, provide information regarding psychological and neurobiological mechanisms, help guide therapeutic choices, and assess the effectiveness of treatment response. [5][6][7] Two of the most important typological models of alcoholism are the classifications established by Cloninger et al 8 and Babor et al 9 Based on the genetic and environmental features of alcoholism vulnerability, Cloninger et al 8 discriminate two subtypes of alcoholism: type I and type II. In clinical terms, type I is defined by a later onset of problem drinking and fewer alcohol-related problems.…”