SummaryIn 54 inpatients with alcohol dependence, an assessment was made at different mental institutions of some clinical conditions that were thought to be implicated in the development of physical alcohol dependence. These patients were divided into three groups according to the presence or absence and severity of withdrawal symptoms, in order to make a comparison between them as to the frequency with which each of these conditions was satisfied.(1) Of the conditions examined, a severe degree of drunkenness with coma and/or incontinence of urine appeared to be the most implicative. This condition was satisfied significantly more frequently in the group presenting withdrawal syndrome than the others (P<0.01). Indeed, the more severe the syndrome, the higher the frequency with which the condition was satisfied.(2) It was also found that some withdrawal symptom or other was manifested significantly more frequently (P<0.011 when two or more of the remaining four conditions were satisfied: poor sleep or sleep for less than four hours a day; alcohol intake as massive as 145 ml or more of pure alcohol a day; regular intake of beverages containing alcohol in high concentrations; and a drunken state persisting throughout the waking hours. In cases where three or more of these conditions were satisfied, more serious psychotic withdrawal symptoms such as delirium tremens or convulsions were of significantly higher incidence (P<0.001).(3) It was thus concluded that some of these conditions, which, when taken individually, do not appear related to physical dependence, do show such a relationship when combined together.(4) None of such factors as predisposition, age, length of drinking history or dietary intake appeared to be of primary importance in the development of physical dependence.(5) A comparative assessment was also made of the results obtained in the present study with previously documented data from animal experiments.
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