In the past 25 years, numerous publications have cited "blackouts" as a major prodromal symptom of alcoholism. In contrast, this study, based on a structured interview with 100 hospitalized alcoholics, revealed that more than one-third of the subjects had never experienced a blackout and that, among those who did report the experience, blackouts generally began well along in the course of alcoholism rather than at an early stage. Blackouts were positively associated with severity and duration of alcoholism, extent and duration of alcohol consumption per drinking episode, capacity for drinking large amounts, "loss of control," neglect of meals, gulping drinks, and a history of head trauma. Only one patient had experienced blackouts after moderate drinking.Abstract Teaser