Alcoholic subtypes: are two sufficient?
Alcoholic subtypes: are two sufficient?
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DOI：
10.1111/j.1360-0443.2004.00878.x
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发表时间：
2004-12-01
期刊：
影响因子：
6
通讯作者：
Scheidt, DM
中科院分区：
文献类型：
--
作者：
Windle, M;Scheidt, DM
目的：在酒精亚型文献的指导下，对大量（n = 802）、不同种族的酒精住院患者样本进行2到5个聚类分析解的评估。设计收集住院患者药物滥用和精神障碍状况、精神病理危险因素和健康结局的个人访谈数据。数据收集于纽约的五个酒精住院治疗机构；三个场景在纽约市，一个在罗切斯特，一个在布法罗。样本包括802名参与者（481名男性和321名女性），具有种族/民族多样性（418名黑人，180名白人，187名西班牙裔，17名其他种族）。通过药物滥用和精神障碍、酗酒家族史、精神病、气质、酒精预期和临床健康变量的标准化测量对受试者进行评估。结果根据内外标准及与现有文献的相容性，将其分为轻度、多药、负性和慢性/反社会四种亚型。在外部标准上，多药亚型的家庭犯罪、高危性行为和静脉吸毒发生率最高；消极情感型儿童儿童期性虐待、自杀未遂和无家可归率最高；慢性/反社会人格（ASP）型儿童酗酒和反社会行为最严重。结论讨论了四亚型方剂的病因学和临床应用，并与分子遗传学和药理学的最新研究结果一致。
Aims Guided by the literature on alcohol subtypes, cluster analytical solutions ranging from two to five were evaluated for a large (n = 802), ethnically diverse sample of alcoholic in-patients.Design Personal interview data were collected from in-patients regarding their substance abuse and psychiatric disorder status, risk factors for psychopathology and health outcomes.Setting The data were collected at five alcohol in-patient treatment settings in New York; three settings were in New York City, one in Rochester and one in Buffalo.Participants The sample included 802 participants (481 males and 321 females) with racial/ethnic group diversity (418 blacks, 180 whites, 187 Hispanics, 17 of other ethnic origin).Measurements Subjects were assessed with standardized measures of substance abuse and psychiatric disorders, family history of alcoholism, psychopathy, temperament, alcohol expectancies and clinical health variables.Findings Based on internal and external criteria and compatibility with the existing literature, four subtypes were identified: mild course, polydrug, negative affect and chronic/antisocial. On external criteria, the polydrug subtype had the highest rate of family criminality, high-risk sexual behavior and intravenous drug use; the negative affect subtype had the highest rate of childhood sexual abuse, attempted suicide and childhood homelessness: the chronic/antisocial personality (ASP) subtype had the most severe pattern of drinking and antisocial behavior.Conclusions Findings are discussed with regard to the etiological and clinical utility of the four-subtype formulation, and consistency with recent studies in molecular genetics and pharmacology.