Clinical approach of alcoholism through affective temperaments

In the recent past multiple efforts have been made to subtype alcoholism beyond ICD-10, mainly in order to take in account the course of the disease and its neurochemistry. The typology of Otto Lesch [1,2] has received considerable attention due to its practical value and its relevance for the prediction of treatment response. While the comorbidity of alcoholism and affective disorder has been thoroughly studied [3], the role of subthreshold affective disturbances and the role of temperament remain unclear. At Vienna University Hospital he have studied consecutive admissions of patients with alcoholism by assessing temperament and subthreshold hypomania. Our data show a clear link of the Lesch typology to the clinical burden of hypomanic and cyclothymic features. Implications for prevention and long-term treatment will be discussed.