Alcohol and Alcoholism Advance Access originally published online on October 17, 2005
Alcohol and Alcoholism 2006 41(1):66-69; doi:10.1093/alcalc/agh227
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RECURRENT DETOXIFICATIONS ARE ASSOCIATED WITH CRAVING IN PATIENTS CLASSIFIED AS TYPE 1 ACCORDING TO LESCH'S TYPOLOGY
Department of Psychiatry and Psychotherapy, University of Erlangen-Nuremberg, Schwabachanlage 6, D-91054 Erlangen, Germany
* Author to whom correspondence should be addressed at: Tel.: +49 9131 8533001; Fax: +49 9131 8534105; E-mail: thomas.hillemacher{at}psych.imed.uni-erlangen.de
(Received 17 June 2005; first review notified 29 August 2005; in final revised form 16 September 2005; accepted 3 October 2005)
Aims: Recurrent detoxifications have been suggested to be associated with elevated alcohol craving. The aim of this investigation was to study the influence of preceding detoxifications on craving in patients with alcoholism classified according to Lesch's typology. Methods: We examined 192 patients (154 men, 38 women) after admission for detoxification treatment. Craving was assessed using the Obsessive Compulsive Drinking Scale, and patients were classified into one of the four subgroups of Lesch's typology. The number of preceding detoxifications was assessed with a structured interview. Results: Lesch's typology type 4 patients showed significantly higher craving scores than type 1–3 patients (Mann–Whitney U-Test; P < 0.05). With respect to the influence of recurrent detoxifications, we found a significant correlation between the number of preceding detoxifications and the extent of craving for the whole population (Spearman's rho r = 0.241, P = 0.001, N = 192), particularly for patients of Lesch's type 1 (Spearman's rho r = 0.534, P = 0.001, N = 37). No significant association was found for patients of the other subgroups (Lesch's type 2–4). Conclusion: The influence of recurrent detoxifications on craving is especially important in patients with Lesch's type 1. Our results underline the importance of the kindling effect particularly in this group of patients, possibly mediated by an increase of glutamatergic neurotransmission. Furthermore, our results emphasize the need to classify patients with alcohol-dependency in addiction research.
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