Subtypes of Alcoholism and Their Role in Therapy

Lesch, Otto-Michael; Walter, Henriëtte

doi:10.1093/oxfordjournals.alcalc.a008221

Cited by 151 publications

(90 citation statements)

References 11 publications

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“…Because of their large variability in a number of alcohol-related traits and behaviors, selectively bred alcohol-preferring rat lines are often seen as possible experimental models of the different types, or typologies, of human alcoholics [1,3,8,19]. According to this hypothesis and taking into account the results of the EPM [4,17] and SI [present study] experiments, alcohol-preferring P and sP rats might represent proper models for those typologies of alcoholics in whom alcohol drinking is primarily driven by a search for anxiety relief [20,21].…”

Section: Discussionmentioning

confidence: 96%

Anxiolytic Effect of Voluntarily Consumed Alcohol in Sardinian Alcohol- Preferring Rats Exposed to the Social Interaction Test

Gessa¹,

Colombo²

2013

J Alcoholism Drug Depend

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Sardinian alcohol-preferring (sP) rats have been selectively bred for high alcohol preference and consumption. Beside alcohol preference, sP rats display inherent high levels of anxiety-related behaviors (evidenced under multiple experimental procedures).The present study was designed to evaluate whether voluntarily consumed alcohol exerted an anxiolytic effect in adult, male sP rats exposed to the social interaction (SI) test. Alcohol-consuming rats were given alcohol under the homecage 2-bottle "alcohol (10%, v/v) vs water" choice regimen with unlimited access for 15 consecutive days. The SI test was conducted on Day 15 of alcohol drinking, one hour into the dark phase of the daily light/dark cycle. Alcohol intake in alcohol-consuming rats averaged approximately 0.9 g/kg in this first hour of the dark phase. Pairs (n=11) of alcohol-consuming rats displayed approximately 3-fold longer times of SI than pairs (n=10) of alcohol-naive rats. These data (a) suggest that voluntarily alcohol intake exerted an anxiolytic effect in sP rats, (b) extend to a different procedure of experimental "anxiety" previous results obtained using the elevated plus maze test, and (c) strengthen the hypothesis that anxiolysis may represent one of the alcohol effects that drive sP rats to consume high amounts of alcohol.

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Section: Discussionmentioning

confidence: 96%

Anxiolytic Effect of Voluntarily Consumed Alcohol in Sardinian Alcohol- Preferring Rats Exposed to the Social Interaction Test

Gessa¹,

Colombo²

2013

J Alcoholism Drug Depend

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“…A distribuição dos tipos de alcoolismo encontrados no presente estudo pode ser comparada com os dados de literatura, principalmente aqueles obtidos em população atendida em ambulatório 17 . As diferenças regionais encontradas também poderiam ser devidas a erros na 4 ressaltaram a importância da correta classificação dos diferentes subtipos de alcoolismo. Esses autores indicam que a correta observância da árvore decisória de classificação necessita ser seguida para homogeneização dos resultados.…”

Section: Discussionunclassified

“…No atendimento dos pacientes diagnosticados como alcoolistas são observados distintos quadros clínicos. A variabilidade observada na intensidade da síndrome de abstinência alcoólica (SAA), nos resultados terapêuticos com medicações ou com psicoterapia, na prevenção da recaída, e também nos diferentes resultados de estudos genéticos com alcoolistas, mostra que diferentes vulnerabilidades biológicas aos efeitos do álcool podem existir [3][4][5][6][7] . Reconhecer as diferenças e individualizar o tratamento é importante para se obter sucesso terapêutico.…”

Section: Introductionunclassified

“…), personalidade (personalidade aditiva típica ou não típica, comportamento passivo) e uso de álcool (potência da adição, tolerância e uso de outras drogas). Os autores propuseram a classificação do alcoolismo em 4 tipos: I, II, III e IV 4,6,16 , com estratégias distintas de tratamento para cada tipo 16 . O Tipo I apresenta SAA grave, muitas vezes com crises convulsivas de abstinência.…”

Section: Introductionunclassified

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Tipologia de Lesch em alcoolistas no Brasil

Zago-Gomes

Nakamura-Palacios

2009

J. bras. psiquiatr.

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Palavras-chaveAlcoolismo, classificação, assistência ambulatorial, diagnóstico. rEsumo objetivos: Alcoolismo é uma doença heterogênea, com apresentações clínicas, resultados terapêuticos e recaídas variáveis, indicando vulnerabilidades biológicas diferentes. A Tipologia de Lesch distingue quatro categorias de alcoolismo: Tipo I -graves sintomas de abstinência; Tipo II -álcool como solução para conflitos; Tipo III -álcool para "tratamento" de desordens psiquiátricas; Tipo IV -alterações neurológicas antes do uso de álcool. Este estudo verificou a aplicabilidade de uma classificação do tipo clínico de alcoolismo pela Tipologia de Lesch em um ambulatório público brasileiro de atendimento especializado de alta demanda. método: Estudo seccional descritivo, que classificou pacientes do ambulatório de alcoolismo do Hospital Universitário da Universidade Federal do Espírito Santo de acordo com a Tipologia de Lesch. resultados: A diferenciação pela Tipologia de Lesch foi facilmente conduzida em um serviço ambulatorial público de alta demanda. De 170 pacientes, 21,2% foram classificados como Tipo I; 29,4%, Tipo II; 28,8%, Tipo III e 20,6%, Tipo IV. Embora os diferentes tipos de alcoolismo tenham diferentes apresentações clínicas, o padrão de ingestão alcoólica, idade da primeira ingestão e tempo de abstinência não diferiram entre os tipos de alcoolismo. conclusão: A distinção do tipo clínico de alcoolismo de acordo com a Tipologia de Lesch foi considerada aplicável em um ambulatório público brasileiro de grande demanda, sendo os dados encontrados semelhantes aos relatados em estudos realizados em diferentes países. A aplicação dessa classificação poderá definir mudanças nas estratégias de enfrentamento individualizadas do alcoolismo, sendo, entretanto, necessários estudos de seguimento para avaliar os resultados terapêuticos das mesmas. therapeutic results and relapses, indicating different biological vulnerability. Lesch et al (1988) AbsTrAcT Objective: Alcohol dependence is a heterogeneous disease with a clear variability in clinical,

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“…A different approach to the classification of alcoholism was suggested by Lesch et al 53,54 . On the basis of a 5-year study including 444 patients, they suggested division into four categories based on family heredity, psychopathology and hypothetical neurobiological basis.…”

Section: Subtypes Of Alcoholismmentioning

confidence: 99%

Neurobiological Bases of Alcohol Addiction

Matošić¹,

Marušić²,

Vidrih³

et al. 2016

ACC

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SUMMARY -Alcohol addiction is a heterogeneous psychiatric disorder according to both phenotype and etiology. Difference in phenotype characteristics manifests in the manner the addiction arises, history of the alcoholic and history of drinking, comorbid disorders, and the phenomenon of abstinence difficulties. Concerning the etiology of alcoholism, the disease itself is considered to be a consequence of an interactive influence of the environment and genetic factors. Numerous researches conducted in the last decades discovered many aspects of the biochemical, cell and molecular bases of alcohol addiction, leading to a conclusion that alcoholism is, like many other addictions, a brain disease. By recognizing alcoholism as a disease which basically implies changes of the neurobiological mechanisms, as well as a clear genetic basis, it was supposed that the disease, having its basis solely in the symptomatology, is essentially heterogeneous. By trying to solve the problem of a clinically heterogeneous nature of the disease during the last fifty years, various sub-classifications of such patients have been suggested. According to Cloninger, subtypes of alcoholism differ also according to changes in the brain neurotransmission systems, i.e. it is supposed that patients suffering from alcoholism type 1 have a more pronounced dopaminergic transmission deficit, while dopaminergic transmission is not disturbed significantly in patients diagnosed with alcoholism type 2, who, however, have a significant lack of serotonergic transmission. In such a way, Cloninger actually presented the basis of the so-called neurobiological alcoholism model. Since he has connected differences in neurotransmission with differences in personality characteristics, this model is also known as the psychobiological model of alcoholism. The characteristic of alcoholism type 1 is avoiding damage (Harm Avoidance, HA) decreased dopamine transmission and increased serotonin transmission, while the significant characteristic of alcoholism type 2 is seeking for excitement (Novelty Seeking, NS), unchanged dopamine transmission and decreased serotonin transmission. These neurochemical differences among alcoholism subtypes represent the basis for a different therapy approach. Intake of alcohol changes different gene expression in the human brain. The inheritance model of alcoholism is not fully explained, however, it is considered that the disease is connected to a larger gene number included in neurotransmission, cell mechanisms and general metabolic function, with a simultaneous influence of the environment. The contribution of genetic factors is stronger in certain types of alcoholism and thus we have been confronted in the last years of alcoholism research with studies researching the connections of some alcoholism subtypes with the polymorphism phenomenon in the genes coding the synaptic proteins included in the alcoholism etiology. The primary role of monoamine oxidase (MAO) in the brain is catalysis of deamination of the oxidative neurotransmitter a...

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Subtypes of Alcoholism and Their Role in Therapy

Cited by 151 publications

References 11 publications

Anxiolytic Effect of Voluntarily Consumed Alcohol in Sardinian Alcohol- Preferring Rats Exposed to the Social Interaction Test

Anxiolytic Effect of Voluntarily Consumed Alcohol in Sardinian Alcohol- Preferring Rats Exposed to the Social Interaction Test

Tipologia de Lesch em alcoolistas no Brasil

Neurobiological Bases of Alcohol Addiction

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