The natural history of alcohol abuse: implications for definitions of alcohol use disorders

Article Abstract:

There is still no general consensus on the proper classification of problems which may arise in an individual's life as a result of the use or abuse of alcohol. The Diagnostic and Statistical Manual of Mental Disorders, third edition revised (DSM-III-R) has made a distinction between alcohol dependence and alcohol abuse. This arises from the conclusion that an individual may abuse alcohol without having a physical addiction. Other researchers have not made this distinction and adhere to one set of criteria to define alcoholism. To further investigate alcohol abuse and dependency, data were analyzed from a study of drinking practices and problems which began in 1969. The ongoing study has been conducted by a research center affiliated with the National Institute on Alcohol Abuse and Alcoholism. The original study consisted of 978 men between the ages of 21 and 59 years; 593 subjects were current drinkers. The subjects were classified after interviews, and conclusions were based on the self-reports of the subjects regarding the effects of their drinking on their work, relationships and health. Of the 593 current drinkers, 71 men were categorized as alcohol abusers and 109 were classified as alcohol dependent. When the group was reassessed four years later in 1973, 74 percent of the original group was available for follow-up. When reassessment was made, 70 percent of those who had been classified as alcohol abusers remained at that status or were in remission; 30 percent had become alcohol dependent. Of the men who had been classified as alcohol dependent, 46 percent still retained that status; the other 54 percent were reclassified as alcohol abusers only or were in remission. Based on these findings, it is concluded that separate categories for alcohol abuse and alcohol dependence may be valid. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Alcoholism, Identification and classification, Men, Alcohol use

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The normalcy of self-proclaimed "normal volunteers"

Article Abstract:

An evaluation was done on a group of 121 individuals who volunteered to participate in clinical studies and who defined themselves as 'normal'. Upon examination, however, 16.5 percent were found to have mental disorders as defined by the Schedule for Affective Disorders and Schizophrenia. In addition, 104 individuals had a past history of a mental disorder and 39.4 percent had family histories of mental illness. The study emphasized the difficulty in screening for 'normal' subjects for use as a control group. The definition of normal is inherently subjective. One of the questions arising from the study that remains unanswered concerns the underlying motivation which may have prompted these individuals to volunteer for clinical studies. A personal or family history of mental illness may be a factor in the willingness of some of these individuals to participate in a study. It was found that a significant portion of the volunteers were women experiencing premenstrual mood changes. A positive correlation was also observed between the volunteers and a family history of affective disorders such as drug abuse, psychoses, and alcoholism. This study emphasizes the importance of in-depth interviews, consideration of family histories, as well as evaluation for any current biological or mental pathologies before subjects are deemed 'normal' for research purposes.

Evaluation, Measurement, Testing, Mental health, Birth defects, Volunteers

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Desipramine-induced urticaria: a clinical problem

Article Abstract:

Skin rashes and urticaria (hives) have recently been associated with desipramine (DMI), an antidepressant. It has been suggested that this is due to an allergy to a dye, yellow number five, which is contained in the tablets, but there have been reports of similar reactions from DMI tablets not containing the dye. To further investigate this, 70 outpatients with depression or panic disorder were followed during a 10-day-period of DMI or placebo treatment, and at six-week intervals thereafter. Both placebo and DMI tablets contained 0.8 milligrams of the dye. Patients who were still symptomatic after the 10 days were openly given DMI for six weeks. All patients receiving DMI developed urticaria after three weeks of treatment. Urticaria disappeared within a few days for most, but one patient required treatment. Symptoms recurred when she began taking a brand of DMI that did not contain the dye. None of the patients developed urticaria while on placebo tablets containing the same amount of dye as the DMI tablets. Therefore, it is likely that DMI alone is responsible for urticaria, which occurs only after blood levels reach a therapeutic level during the third or fourth weeks. Antihistamines may be effective in relieving symptoms of this side effect. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Complications and side effects, Drug therapy, Depression, Mental, Depression (Mood disorder), Urticaria, Hives (Disease), Panic disorders, Panic disorder, Desipramine

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