Driessen M, Veltrup C, Wetterling T, John U, Dilling H
Department of Psychiatry, Luebeck School of Medicine, Germany.
Alcohol Clin Exp Res. 1998 Feb;22(1):77-86.
Although high prevalence rates of psychiatric comorbidity were reported in alcoholism, there is a lack of studies covering the whole spectrum of DSM Axes I and II disorders. The relation of comorbid psychopathology and Cloninger's and Babor's types of alcoholism still remained unclear.
Psychiatric comorbidity in 250 hospitalized alcohol-dependent patients without additional substance-related disorders was assessed by the Composite International Diagnostic Interview and the International Personality Disorder Examination. Information about the course and severity of alcoholism was obtained from several sources.
Additional Axis I disorders only were found in 24.0%, Axis II disorders only in 16.4%, and concurrent Axis I and Axis II disorders in 17.2% (total comorbidity rate: 57.6%). Two clusters of alcohol dependence were found that substantially overlap with Cloninger's and Babor's types of alcoholism. The majority of type A subjects were found to be either not comorbid at all, or to be Axis I comorbid only. Type B, on the other hand, was preferably associated with personality disorders (mainly Clusters A and B) and dimensional scores of personality pathology (schizoid, schizotypal, all Cluster B, and passive-aggressive).
The entire spectrum of personality pathology should be assessed in the comorbidity research of alcoholism. The two types of alcoholism differ on a variety of alcohol-related and comorbid personality characteristics, but further research is needed to clarify the underlying psychological and biological associations.
尽管酒精中毒患者中精神疾病共病的患病率较高，但缺乏涵盖《精神疾病诊断与统计手册》（DSM）轴I和轴II所有障碍类型的研究。共病精神病理学与克隆宁格和巴伯的酒精中毒类型之间的关系仍不明确。
通过综合国际诊断访谈和国际人格障碍检查，对250名无其他物质相关障碍的住院酒精依赖患者的精神疾病共病情况进行评估。从多个来源获取有关酒精中毒病程和严重程度的信息。
仅发现轴I障碍的患者占24.0%，仅发现轴II障碍的患者占16.4%，同时存在轴I和轴II障碍的患者占17.2%（共病率总计：57.6%）。发现了两类酒精依赖，它们与克隆宁格和巴伯的酒精中毒类型有很大重叠。大多数A型患者要么根本没有共病，要么仅存在轴I共病。另一方面，B型患者更常伴有个性障碍（主要是A组和B组）以及个性病理学的维度评分（分裂样、分裂型、所有B组以及被动攻击型）。
在酒精中毒共病研究中应评估整个个性病理学范围。两种酒精中毒类型在多种与酒精相关的共病个性特征方面存在差异，但需要进一步研究以阐明潜在的心理和生物学关联。
