NIH Radio
Researchers Identify Alcoholism Subtypes
Brief Description:
In a report that should help dispel the notion of the "typical alcoholic," five distinct subtypes of the disease have been identified by scientists at the National Institute of Alcohol Abuse and Alcoholism, part of the National Institutes of Health.
Transcript:
Schmalfeldt: In a report that should help dispel the notion of the "typical alcoholic," five distinct subtypes of the disease have been identified by scientists at the National Institute of Alcohol Abuse and Alcoholism, part of the National Institutes of Health. Previous efforts to identify alcoholism subtypes focused primarily on individuals who were hospitalized or otherwise receiving treatment of their alcoholism. However, recent reports from the NIAAA's National Epidemiologic Survey on Alcohol and Related Conditions — also known as NESARC — suggest that only about one-fourth of people with alcoholism have ever received treatment, meaning a substantial proportion of people with alcoholism were not represented in the samples previously used to define subtypes of this disease. The current study focused on the nearly 1,500 NESARC survey respondents who met diagnostic criteria for alcohol dependence, and included individuals in treatment as well as individuals not seeking treatment.
The researchers identified unique subtypes of alcoholism based on the respondents' family history of alcoholism, age of onset of regular drinking and alcohol problems, symptom patterns of alcohol dependence and abuse, and the presence of additional substance abuse and mental disorders. There's the "Young Adult" subtype — comprising 31.5 percent of American alcoholics. These are young adult drinkers with relatively low rates of co-occurring substance abuse and other mental disorders, a low rate of family alcoholism, who rarely seek any kind of help for their drinking.
There's the "Young Antisocial" subtype — 21 percent of US alcoholics. They tend to be in their mid-twenties, had early onset of drinking and alcohol problems. More than half come from families with alcoholism, and about half have a psychiatric diagnosis of Antisocial Personality Disorder. Many have major depression, bipolar disorder and anxiety problems, and more than 75 percent of this group smoked cigarettes and marijuana. Many also had cocaine and opiate addictions. More than a third of this group seek help for their drinking.
Third is the "Functional" subtype. This group makes up about 19.5 percent of American alcoholics. They are typically middle-aged, well-educated with stable jobs and families. About a third of them have a multigenerational family history of alcoholism, about a quarter of the group had major depressive illness sometime in their lives — nearly 50 percent were smokers. The fourth group is the "Intermediate Familial" subtype. This group makes up 19 percent of US alcoholics. They are middle-aged with about 50 percent coming from families with multigenerational alcoholism. Almost half have suffered from clinical depression, and 20 percent had bipolar disorder. Most were tobacco smokers, and nearly one in five had problems with cocaine and marijuana use. Only 25 percent of this group ever sought treatment for problem drinking.
Finally, there's the "Chronic Severe" subtype. Making up 9 percent of American alcoholics, this group is mostly middle-aged individuals who had early onset of drinking and alcohol problems withhigh rates of Antisocial Personality Disorder and criminality. Almost 80 percent of this group come from families with multigenerational alcoholism. They have the highest rates of other psychiatric disorders, including depression, bipolar disorder, and anxiety disorders as well as high rates of smoking, and marijuana, cocaine and opiate dependence. Two-thirds of these alcoholics seek help for their drinking problems, making them the most prevalent type of alcoholic in treatment. The study authors also reported that co-occurring psychiatric and other substance abuse problems are associated with the severity of alcoholism and entering into treatment. Attending AA meetings and other 12-step programs is the most common form of help-seeking for drinking problems. I'm Bill Schmalfeldt in Bethesda, Maryland.
About This Audio Report
Date: 7/13/2007
Reporter: Bill Schmalfeldt
Topic: Alcohol Abuse
Institute(s): NIAAA
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