Are the binary typology models of alcoholism valid in polydrug abusers? 

Samuel Pombo, Nuno Félix da Costa, Maria Luísa Figueira

Revista Brasileira de Psiquiatria. 2014;00:00–00

Objective: The study aims to evaluate the dichotomy type I/II and Type A/B alcoholism typologies in Opiate Dependent Patients with a co-morbid Alcohol Dependence Problem (ODP-AP).

Methods: The validity process comprised the information regarding the history of alcohol use (internal validity), cognitive-behavioural variables regarding substance use (external validity) and indicators of treatment in a 6-month follow-up (predictive validity).

Results: ODP-AP subjects classified as type II/B presented an early and much more severe drinking problem and a worse clinical prognosis when considering opiate treatment variables, when comparing with ODP-AP subjects defined as type I/A. Also, type II/B patients endorse more general positive beliefs and expectancies related to alcohol effect and tend to drink heavily across several intra-inter personal situations, when comparing with type I/A.

Conclusions: The study results confirmed two different forms of alcohol dependence, recognized as Low-Severity/Vulnerability Subgroup (LSVS) and High-Severity/Vulnerability Subgroup (HSVS), in an opiate dependent population with lifetime diagnosis of alcohol dependence.

http://www.scielo.br/pdf/rbp/2014nahead/1516-4446-rbp-1516-4446-2014-1384.pdf

Alexithymia and alcohol dependence: Do different subtypes manifest different emotion regulations?

• Addiction Research & Theory
• August 21, 2014
• • 
    

Authors: Samuel Pombo, et al.

Objective: Alcohol abusers are vulnerable to emotional disabilities. Studies have shown that alexithymia is significantly associated with alcohol dependence and many other phenotypic descriptors. Given the high phenotypic heterogeneity that characterises the alcohol dependence syndrome, the study aims to assess alexithymia features according to a multivariate classification scheme of alcoholism - the Lesch Alcoholism Typology (LAT).
Methods: A total of 274 alcohol dependence outpatients (DSM diagnosis) were recruited from the Alcoholism Unit of the Psychiatric Service of Santa Maria University Hospital. After a detailed clinical observation, subjects were evaluated with the alcoholism classification system (LAT) and self-rated alexithymia with the Toronto Alexithymic Scale - 20 items (TAS-20).
Results: Data showed that almost half of the alcohol dependent individuals were defined as alexithymic cases (48.5%). “Organic” alcohol dependent patients (type IV of Lesch classification) presented higher scores in TAS-20 when compared to other subtypes, even after controlling for potential confounding factors. Furthermore, the TAS-20 scores were related to educational level and family history of alcoholism.
Conclusions: Results indicate that the alexithymia construct is an important psychological dimension in the characterisation of alcohol dependence, especially the alcohol dependent phenotypes that are more likely to present co-existing organic complications.

https://www.researchgate.net/publication/264930134_Alexithymia_and_alcohol_dependence_Do_different_subtypes_manifest_different_emotion_regulations?ev=prf_pub

The role of 5-HTTLPR polymorphism in alcohol craving experience

• 
  
• Samuel Pombo^a, , , 
• Joana Ferreira^b, 
• José Maria Neves Cardoso^a, 
• Fátima Ismail^a, 
• Pilar Levy^b, 
• Manuel Bicho^b

The way in which genetic risk mediates the development of craving in alcohol dependence is still relatively unknown. The authors sought to clarify the extent to which alcohol craving could be predicted by a relevant polymorphism in the promoter region of the gene encoding the 5-HT transporter (5-HTTLPR). A sample of 101 alcohol-dependent patients admitted for alcohol treatment was recruited for the study. At admission, blood samples were taken for DNA extraction and alcohol craving information was collected with a composite measure. The 5-HTT polymorphism was genotyped. Alcohol dependent patients who were homozygous for the long allele (LL) self-reported higher scores of craving when compared to patients that were homozygous for the short allele (SS). However, the results were not statistically significant. Also, no significant associations were observed between the 5-HTTLPR genotype and other drinking variables. No 5-HTTLPR genotype effects were observed on alcohol craving experience in a sample of alcohol-dependent outpatients.

http://www.sciencedirect.com/science/article/pii/S0165178114003230