Malhotra Savita, Basu Debasish, Ghosh Abhishek, Khullar Madhu, Kakkar Neeraj
Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Psychiatry. 2016 Oct-Dec;58(4):372-377. doi: 10.4103/0019-5545.196707.
Two cluster solutions for the subtyping of alcohol dependence (AD) was investigated in an Indian male population. Subtypes were compared for various personality traits and childhood externalizing disorders. They were also compared with respect to single-nucleotide polymorphisms (SNP) of various candidate genes.
This was a clinic-based study conducted among 202 patients with AD. All patients were assessed with SSAGA-II for comorbid antisocial personality disorder (ASPD) and childhood conduct disorder (CD), oppositional defiant disorder (ODD), and attention deficit hyperactivity disorder (ADHD). For the assessment of personality traits, the Indian Adaptation of Sensation Seeking Scale (SSS) and Barratt's Impulsiveness Scale were administered. SNP genotyping was done using taqmann assay by real-time polymerase chain reaction.
Among those with AD, the two-cluster model which was able to produce the maximum degree of cohesion among disorders in the same cluster and separateness from the other cluster was the one with or without ASPD and CD. The quality of the cluster analysis was reduced when ODD and ADHD were included in the model along with ASPD and CD. Thus, in our index population, there are two distinct clusters of AD, one with ASPD and CD or the externalizing cluster (Cluster 2) and the other without ASPD and CD or the nonexternalizing cluster (Cluster 1). Externalizing cluster had significantly higher score in both the impulsiveness and the SSS. This cluster was also significantly associated with childhood ADHD and ODD. The genotype frequencies of all candidate genes were found to be nonsignificantly distributed among the two groups.
Our study has conferred a cross-cultural validation of the known alcoholism subtypes.
在印度男性人群中研究酒精依赖（AD）亚型的两种聚类解决方案。比较各亚型的各种人格特质和儿童期外化障碍。还比较了各候选基因单核苷酸多态性（SNP）情况。
这是一项基于门诊的研究，纳入202例AD患者。所有患者均采用SSAGA-II评估共病的反社会人格障碍（ASPD）以及儿童期品行障碍（CD）、对立违抗障碍（ODD）和注意缺陷多动障碍（ADHD）。采用印度版感觉寻求量表（SSS）和巴拉特冲动性量表评估人格特质。通过实时聚合酶链反应的taqmann分析法进行SNP基因分型。
在AD患者中，能在同一聚类中的障碍之间产生最大程度凝聚性且与另一聚类区分开来的双聚类模型是包含或不包含ASPD和CD的模型。当模型中除ASPD和CD外还纳入ODD和ADHD时，聚类分析质量下降。因此，在我们的研究人群中，有两种不同的AD聚类，一种有ASPD和CD即外化聚类（聚类2），另一种没有ASPD和CD即非外化聚类（聚类1）。外化聚类在冲动性和SSS上得分均显著更高。该聚类也与儿童期ADHD和ODD显著相关。所有候选基因的基因型频率在两组间分布无显著差异。
我们的研究对已知的酒精中毒亚型进行了跨文化验证。
