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Am J Psychiatry 1993; 150:786-792
Copyright © 1993 by American Psychiatric Association
Clinical course of alcoholism in 636 male inpatients
MA Schuckit, TL Smith, R Anthenelli and M Irwin
Department of Psychiatry, University of California, School of Medicine, San Diego.
OBJECTIVE: This study was undertaken to determine the relative order of
appearance of symptoms in alcohol dependence. METHOD: The age at which 21
alcohol-related major life events first occurred was investigated in 636
male alcohol-dependent inpatients through a standardized, structured
personal interview with each subject and at least one resource person.
RESULTS: A general pattern of first occurrence of these events was
observed. Heavy drinking escalated further when the subjects were in their
late 20s, followed by evidence of interference with functioning in multiple
life areas in the early 30s, a subsequent perception of loss of control,
and then an intensification of social and job-related problems, along with
evidence of deterioration in body systems, in the mid- to late 30s. Similar
patterns of problems emerged when the alcoholic subjects were divided into
subgroups based on onset of alcohol dependence before or after age 30,
presence or absence of a family history of alcoholism, and presence or
absence of additional psychiatric disorders. CONCLUSIONS: These data
indicate that there is a typical progression of events related to alcohol
dependence. This information can be useful for clinicians in their work
with patients and for teachers and researchers as well.
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