Subtypes of alcohol dependence in a nationally representative sample

• Published in: Drug and alcohol dependence Vol. 91; no. 2; pp. 149 - 158
• Main Authors: Moss, Howard B, Chen, Chiung M, Yi, Hsiao-ye
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.12.2007; Elsevier Science
• Subjects: Addictive behaviors; Adult; Adult and adolescent clinical studies; Age of Onset; Alcohol dependence; Alcoholism; Alcoholism - classification; Alcoholism - epidemiology; Alcoholism - genetics; Alcoholism - psychology; Alcoholism and acute alcohol poisoning; Biological and medical sciences; Continental Population Groups; Diagnostic and Statistical Manual of Mental Disorders; Educational Status; Epidemiology; Ethnic Groups; Female; General aspects; Health Surveys; Humans; Male; Medical sciences; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Public health. Hygiene; Public health. Hygiene-occupational medicine; Reproducibility of Results; Socioeconomic Factors; Subtypes; Survey research; Toxicology; United States - epidemiology; United States; Survey research; Alcohol dependence; Subtypes; Epidemiology; Human; Drug addiction; Alcoholism; Sample; Survey; Addiction; Surveillance; Scientific research; Dependence; Psychiatry; Public health
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2007.05.016

Abstract Objective The authors sought to empirically derive alcohol dependence (AD) subtypes based on clinical characteristics using data from a nationally representative epidemiological survey. Method A sample of 1484 respondents to the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) with past year AD was subjected to latent class analysis in order to identify homogeneous subtypes. Results The best-fitting model was a five-cluster solution. The largest cluster (Cluster 1: ∼31%) was comprised of young adults, who rarely sought help for drinking, had moderately high levels of periodic heavy drinking, relatively low rates of comorbidity, and the lowest rate of multigenerational AD (∼22%). In contrast, Clusters 4 and 5 (∼21% and 9%, respectively) had substantial rates of multigenerational AD (53% and 77%, respectively), had the most severe AD criteria profile, were associated with both comorbid psychiatric and other drug use disorders, lower levels of psychosocial functioning, and had engaged in significant help-seeking. Clusters 2 and 3 (∼19% each) had the latest onset, the lowest rates of periodic heavy drinking, medium/low levels of comorbidity, moderate levels of help-seeking, and higher psychosocial functioning. Conclusion Five distinct subtypes of AD were derived, distinguishable on the basis of family history, age of AD onset, endorsement of DSM-IV AUD criteria, and the presence of comorbid psychiatric and substance use disorders. These clinically relevant subtypes, derived from the general population, may enhance our understanding of the etiology, treatment, natural history, and prevention of AD and inform the DSM-V research agenda.