Meyer R E
Psychiatr Clin North Am. 1986 Sep;9(3):435-53.
The alcohol dependence syndrome is at once a fresh approach and a restatement of established clinical lore. It is, perhaps, old wine in a new bottle. Nonetheless, behavioral researchers in this field have needed some clinically sound criteria to differentiate between subjects to account for the variability of behavioral and psychophysiologic responses to alcohol in the laboratory. Cross-cultural researchers, and those interested in the genetics of alcoholism, have needed culture-free criteria for the diagnosis of alcoholism that might help them to separate aspects of the disorder that are genetically determined from those that are influenced by culture, immediate environment, and psychopathology. The beauty of the alcohol-dependence syndrome construct is its apparent specificity and its potential clinical usefulness. The difficulty with the concept is that no questionnaire has proven entirely satisfactory in defining the severity of alcohol dependence nor have biologic variables been identified that can provide valid and reliable indicators of severity. Nonetheless, advances in biomedical research frequently await the development of a nomenclature that will permit replicable scientific investigation. The evolving definition of the alcohol dependence syndrome is consistent with this tradition.
酒精依赖综合征既是一种全新的方法，也是对既定临床知识的重新阐述。这或许就是新瓶装旧酒。尽管如此，该领域的行为研究人员需要一些临床合理的标准来区分研究对象，以解释实验室中对酒精的行为和心理生理反应的变异性。跨文化研究人员以及对酒精中毒遗传学感兴趣的人员，需要无文化差异的酒精中毒诊断标准，这可能有助于他们区分该疾病中由基因决定的方面与受文化、直接环境和精神病理学影响的方面。酒精依赖综合征这一概念的美妙之处在于其明显的特异性及其潜在的临床实用性。该概念的难点在于，尚无问卷能在界定酒精依赖严重程度方面完全令人满意，也未发现能提供有效且可靠严重程度指标的生物学变量。尽管如此，生物医学研究的进展往往等待着一种能允许进行可重复科学研究的命名法的发展。酒精依赖综合征不断演变的定义与这一传统是一致的。
