Limosin F, Gorwood P, Adès J
Service du Professeur Adès, Centre Hospitalo-Universitaire Louis Mourier, Colombes.
Presse Med. 1996 Oct 26;25(32):1550-4.
Alcoholism is a complex disorder, with clinical and etiological heterogeneity. The clinical symptoms used for the diagnostic of alcoholism are based on worldwild standard criteria, such as DSM (American Psychiatric Association) or ICD (World Health Organisation). Good agreement between clinicians for the diagnostic of alcoholism can be obtained with these classifications. The diagnostic of alcoholism with such international criteria is mainly based on the cognitive and behavior consequences of alcohol consumption. In order to cope with the heterogeneity of alcoholism, one should analyse the different aspects of alcoholism pathogenesis. One important aspect is its high frequency within some families, as many studies show a direct correlation between the risk for alcoholism and familial frequency of alcoholism. More recent studies tried to detect which clinical aspects of alcoholism are more frequently observed in alcoholic patients with a positive familial history. Those studies also analysed the impact of a familial history of co-morbid psychiatric disorders on the general risk for alcoholism and the specific risk for alcoholism and co-morbid psychiatric disorders. Most clinicians interested in alcoholism look for familial history of alcoholism or psychiatric disorders, but this information is frequently incomplete and partially used. The research on familial history of alcoholism is nevertheless facilitated, and more valid, with the recent clinical tools such as standard clinical questionnaires. The detection of a familial history can be in many aspects useful for establishing clinical subtypes, predicting specific (psychiatric, social or medical) complications, or helping to find the most relevant treatment modality.
酒精中毒是一种复杂的疾病，具有临床和病因学异质性。用于诊断酒精中毒的临床症状基于全球标准，如《精神疾病诊断与统计手册》（美国精神病学协会）或《国际疾病分类》（世界卫生组织）。使用这些分类，临床医生在酒精中毒诊断上可达成良好的一致性。采用此类国际标准诊断酒精中毒主要基于饮酒的认知和行为后果。为应对酒精中毒的异质性，应分析酒精中毒发病机制的不同方面。一个重要方面是其在某些家族中的高发性，因为许多研究表明酒精中毒风险与家族中酒精中毒发生率之间存在直接关联。最近的研究试图检测在有阳性家族史的酒精中毒患者中，哪些酒精中毒的临床方面更常出现。这些研究还分析了共病精神障碍家族史对酒精中毒总体风险以及酒精中毒与共病精神障碍特定风险的影响。大多数对酒精中毒感兴趣的临床医生会寻找酒精中毒或精神障碍的家族史，但这些信息往往不完整且使用不充分。不过，借助标准临床问卷等最新临床工具，对酒精中毒家族史的研究变得更加便利且更具效度。家族史的检测在许多方面有助于确定临床亚型、预测特定（精神、社会或医学）并发症，或帮助找到最相关的治疗方式。
