Alcoholism and antisocial personality.

The picture of alcoholism in criminals with an antisocial personality was compared with criminals with other personality disorders. Fewer of those who had an antisocial personality were physically dependent on alcohol than those with other personality disorders. They considered their alcoholism to be a problem and behaved as if it were only rare. However, they had a strong tendency to behave abnormally under the influence of alcohol over and over again. In these respects the situation among those who were below the age of 20 was similar. To a great extent, the fathers of those who had an antisocial personality had also had a tendency towards abnormal behavior under the influence of alcohol. This was not so often found in the control group.     

Alcoholism and antisocial personality. The sociobiology of an addiction

Alcohol consumption may become adaptive from the evolutionary viewpoint when drinking settings and intoxication can be used to enhance the "cheating" reproductive strategy of antisocial personality disorder. This may explain the selective pressures leading to the association of familial alcoholism and antisocial personality disorder.     

Alcoholism and antisocial personality. Interrelationships, genetic and environmental factors

In a sample of 127 male and 87 female adult adoptees, antisocial personality and alcohol abuse were related to biologic backgrounds and to environmental factors. In the men, alcohol abuse was increased by a background of problem drinking in first-degree biologic relatives and by drinking problems in the adoptive home. Antisocial personality occurred more frequently in men whose first-degree biologic relatives had antisocial behavior problems. In the women, alcohol abuse was increased in adoptees whose first-degree relatives had problem drinking. Increased alcohol abuse in men and women was not predicted by biologic first-degree relatives with antisocial problems, nor did increased frequency of antisocial personality occur in adoptees with biologic relatives with problem drinking. The results suggest specificity of inheritance of antisocial and alcoholic conditions and the importance of environmental factors.     

Alcoholism and Epilepsy

There is a scarcity of population-based epidemiological investigations concerning the prevalence of epilepsy among alcoholics, and of alcoholism among epileptic patients. Available data seem to suggest that the prevalence of epilepsy among alcoholics is at least triple that in the general population, and that alcoholism may be more prevalent among epileptic patients than in the general population. The term "alcoholic epilepsy" has been used with varying definitions in different investigations. It is suggested that a uniform definition be adopted so as to minimize confusion when comparing data from different laboratories. Although there is general agreement that excessive alcohol intake can increase the frequency of seizures in epileptic patients, limited available data suggest that light to moderate social alcohol drinking may not affect seizure frequency. However, epileptic patients should be warned about the possible adverse effects of alcohol, especially those who have refractory forms of epilepsy. Except for a few anomalous cases, evidence for the direct seizure-provoking effect of alcohol is not strong. This is because it is difficult to pinpoint alcohol as the only etiology; more likely, alcohol is only one factor among others (e.g., head trauma, cerebral infarct, alcohol withdrawal, and metabolic effects of alcohol) in provoking seizures. Because seizures are a symptom and not a disease, it is often difficult to distinguish epileptic seizures from alcohol-withdrawal seizures. Patients with only the latter kind of seizures should not need chronic antiepileptic medication.     

Alcoholism and psychiatric disorder

Over the past 50 years the relationship between alcoholism and psychiatric disorders, such as depression, anxiety and schizophrenia, has been the subject of a great deal of research. Psychiatric problems have been seen as both a cause and a result of alcoholism. Whatever the relation between alcoholism and psychiatric disorder is, it may have significance for the development of differentially effective treatment strategies. Several authors have argued that the presence and nature of psychiatric symptoms should form the basis of a classification system for alcoholics. Given the potential rewards of such a system for both understanding the aetiology of alcoholism and developing effective treatment strategies, it is important to have a clear picture of the nature and extent of this relationship. This paper reviews critically the published studies of the association between alcoholism and psychiatric disorder and outlines directions for future research.     

Alcoholism and other psychiatric disorders

Primary alcoholics may display symptoms of affective or psychotic disorders, while mentally ill patients may develop persistent alcohol-related problems. The author discusses the importance of distinguishing alcoholic psychosis from schizophrenia and alcohol-induced confusion from organic brain syndrome. He then outlines the diagnosis and treatment of other alcohol-induced conditions such as alcoholic dementia, antisocial behavior, and drug abuse. After stressing that primary alcoholism can mimic almost any psychiatric disorder, and secondary alcohol abuse can exacerbate any psychiatric symptoms, the author asserts that physicians should routinely include substance abuse as part of the differential diagnosis of psychiatric patients.     

Alcoholism and seasonal affective disorder

Seasonal changes in mood and behavior (seasonality) may be closely related to alcoholism. Some patients with alcoholism have a seasonal pattern to their alcohol misuse. They may be self-medicating an underlying seasonal affective disorder (SAD) with alcohol or manifesting a seasonal pattern to alcohol-induced depression. Both genetic and environmental factors play a role in the etiology and pathogenesis of alcoholism and SAD, operating, at least in part, through the brain serotonergic system. Family and molecular genetic studies suggest that there may be a genetic link between seasonality and alcoholism. Certain environmental and social factors may contribute to the development of seasonality in patients with alcoholism. The fact that SAD and alcoholism may be comorbid shows the importance of a thorough diagnostic interview. Both mental health and drug and alcohol professionals should be provided with education to assist with appropriate identification, management, and referral of patients presenting with comorbid alcoholism and SAD.     

慢性酒精中毒与脑血管病

脑血管病是危害人类生命与健康的常见病和多发病,而酒精中毒是引发脑血管病变不容忽视的原因之一。本文通过总结酒精中毒引发脑血管病的流行病学及其发病机制来阐述酒精中毒与脑血管病的关系。酒精中毒主要是通过导致高脂血症、高血压、血小板凝集性异常、减少脑局部血流量、诱发心律失常及离子紊乱等方面促使卒中的发生。     

Alcoholism and the consultation-liaison psychiatrist

This article hopes to remind the practitioner that alcohol abuse and dependence is the most common of psychiatric disorders, impacts on the general hospital at a variety of levels, repels our referrant-colleagues, and is difficult to diagnose but is eminently treatable. Because both clinicians and their patients are subject to alcohol abuse and dependence, the consultation-liaison psychiatrist is in an ideal position to impact therapeutically on alcoholism at all levels of presentation. Alcoholism is a natural object of a consultation-liaison psychiatrist's time, interest, and energy.