Skip to main content Accessibility help
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 2
  • Print publication year: 2008
  • Online publication date: August 2009

10 - Alcohol problems

from Section 2 - Psychiatric Disorders


This chapter outlines the historical background of alcohol problems, current classificatory systems for diagnosis, psychological and physical related disorders, and the epidemiology of alcohol disorders. A variety of research methodologies have been adopted to examine the relative contribution of genetic and environmental factors to alcohol dependence. Explanatory models for age and sex differences in adolescent drug use can be derived from a variety of theories, including social learning theory and social control theory. The general protocol is adapted from that developed for nicotine dependence and is a useful way to formulate the assessment process, because it translates into specific management plans. Psychological treatments are pivotal to treatment effectiveness, even when pharmacological treatments are administered. The relationships between alcoholism and other psychiatric disorders are some times complex, and it is not always easy to achieve abstinence from alcohol to make an adequate assessment of the nature of the relationship.


Anderson, P. (2004). Editorial: state of the world's alcohol policy. Addiction 99:1367–9.
Anderson, R. A., Jr., Willis, B. R., Oswald, C., et al. (1983). Ethanol-induced male infertility: impairment of spermatozoa. J Pharmacol Exp Ther 225:479–86.
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. (DSM-IV). Washington, DC: American Psychiatric Association.
Assanangkornchai, S., Noi-pha, K., Saunders, J. B., et al. (2003). Aldehyde dehydrogenase 2 genotypes, alcohol flushing symptoms and drinking patterns in Thai men. Psychiatry Res 118:9–17.
Babor, T., Caetano, R., Casswell, S., et al. (2003). Alcohol: No Ordinary Commodity. Oxford: Oxford University Press.
Ball, D. (2004). Genetic approaches to alcohol dependence. Br J Psychiatry 185:449–51.
Baptista, A., Bianchi, L., Groote, J. D., et al. (1981). Alcoholic liver disease: morphological manifestations. Review by an international group. Lancet 1:707–11.
Barnow, S., Schuckit, M. A., Lucht, M., et al. (2002). The importance of a positive family history of alcoholism, parental rejection and emotional warmth, behavioral problems and peer substance use for alcohol problems in teenagers: a path analysis. J Stud Alcohol 63:305–15.
Becker, U. (1993). The influence of ethanol and liver disease on sex hormones and hepatic oestrogen receptors in women. Dan Med Bull 40:447–59.
Becker, U., Deis, A., Sorensen, T. I., et al. (1996). Prediction of risk of liver disease by alcohol intake, sex, and age: a prospective population study. Hepatology 23:1025–9.
Berglund, M., Thelander, S., & Jonsson, E. (2003). Treating Alcohol and Drug Abuse: An Evidence Based Review. Weinheim, Germany: Wiley-VCH Verlag.
Beyers, J. M., Toumbourou, J. W., Catalano, R. F., et al. (2004). A cross-national comparison of risk and protective factors for adolescent substance use: the United States and Australia. J Adolesc Health 35:3–16.
Bierut, L. J., Saccone, N. L., Rice, J. P., et al. (2002). Defining alcohol-related phenotypes in humans. The Collaborative Study on the Genetics of Alcoholism. Alcohol Res Health 26:208–13.
Blum, K., Noble, E. P., Sheridan, P. J., et al. (1990). Allelic association of human dopamine D2 receptor gene in alcoholism. JAMA 263:2055–60.
Bohman, M. (1978). Some genetic aspects of alcoholism and criminality. A population of adoptees. Arch Gen Psychiatry 35:269–76.
Brady, K. T., & Sonne, S. C. (1995). The relationship between substance abuse and bipolar disorder. J Clin Psychiatry 56:19–24.
Brooke, D., Edwards, G., Taylor, C., et al. (1991). Addiction as an occupational hazard: 144 doctors with drug and alcohol problems. Br J Addict 86:1011–16.
Cadoret, R., Troughton, E., Woodworth, G., et al. (1994). Evidence of heterogeneity of genetic effect in Iowa adoption studies. Ann N Y Acad Sci 708:59–71.
Campo, S., Brossard, D., Frazer, M. S., et al. (2003). Are social norms campaigns really magic bullets? Assessing the effects of students' misperceptions on drinking behavior. Health Commun 15:481–97.
Carrigan, M. H., & Randall, C. L. (2003). Self-medication in social phobia: a review of the alcohol literature. Addict Behav 28:269–84.
Carroll, J. F. X. (1984). The substance abuse problem checklist: a new clinical aid for drug and/or alcohol dependency treatment. J Subst Abuse Treat 1:31–6.
Catalano, R. F., & Hawkins, J. D. (1996). The Social Development Model. Delinquency and Crime. Cambridge: Cambridge University Press: pp. 149–97.
Charness, M. E. (1993). Brain lesions in alcoholics. Alcohol Clin Exp Res 17:2–11.
Chick, J. (1989). Delirium tremens. BMJ 298:3–4.
Clifford, C. A., Hopper, J. L., Fulker, D. W., et al. (1984). A genetic and environmental analysis of a twin family study of alcohol use, anxiety, and depression. Genet Epidemiol 1:63–79.
Cloninger, C. R., Bohman, M., Sigvardsson, S., et al. (1981). Inheritance of alcohol abuse. Cross-fostering analysis of adopted men. Arch Gen Psychiatry 38:861–8.
Conway, K. P., Swendsen, J. D., Merikangas, K. R., et al. (2003). Alcohol expectancies, alcohol consumption, and problem drinking: the moderating role of family history. Addict Behav 28:823–36.
Cook, C. C., Hallwood, P. M., Thomson, A. D., et al. (1998). B Vitamin deficiency and neuropsychiatric syndromes in alcohol misuse. Alcohol Alcohol 33:317–36.
Cook, C. H., & Gurling, H. H. D. (1990). The genetic aspects of alcoholism and substance abuse: a review. In G. Edwards & M. Lader, eds. The Nature of Drug Dependence. Oxford: Oxford Medical Publications.
Cotton, N. S. (1979). The familial incidence of alcoholism: a review. J Stud Alcohol 40:89–116.
Crawford, V., Crome, I. B. & Clancy, C. (2003). Co-existing problems of mental health and substance misuse (dual diagnosis): a literature review. Drugs Educ Prevent Policy 10:S1–S74.
Crisp, A. H., Gelder, M. G., Rix, S., et al. (2000). Stigmatisation of people with mental illnesses. Br J Psychiatry 177:4–7.
Crome, I. B. (1995). The experiences of withdrawal and craving in alcohol and opiate dependence [MD thesis]. Birmingham: University of Birmingham.
Crome, I. B., Ghodse, H., Gilvarry, E., et al., eds. (2004). Young People and Substance Misuse. London: Gaskell.
Crome, I. B., & Shaikh, N. (2004). Undergraduate medical education in substance misuse in Britain III: can medical students drive change? Drugs Educ Prevent Policy 11:483–503.
Crome, I. B. (1999). Substance misuse and psychiatric comorbidity: towards improved service provision. Drugs Educ Prevent Policy 6:154–71.
Crome, I. (2004). The process of assessment. In I. B. Crome, A. H. Ghodse, E. Gilvarry, et al., eds. Young People and Substance Misuse. London: Gaskell, pp. 129–39.
Currie, S. P., Clark, S., Hodgins, D. C., et al. (2004). Randomised controlled trial of brief cognitive behavioural interventions for insomnia in recovering alcoholics. Addiction 99:1121–32.
Davidson, R. J., & Raistrick, D. (1986). The validity of the Short Alcohol Dependence Data (SADD) questionnaire. Br J Addict 81:217–22.
Dee, T. S. (2001). Alcohol abuse and economic conditions: evidence from repeated cross-sections of individual-level data. Health Econ 10:257–70.
Drummond, D. C. (1990). The relationship between alcohol dependence and alcohol related problems in a clinical population. Br J Addict 85:357–66.
Drummond, D. C. (2000). What does cue-reactivity have to offer clinical research? Addiction 95(Suppl 2):S129–44.
Dufour, D. R., Lott, J. A., Nolte, F. S., et al. (2000). Diagnosis and monitoring of hepatic injury. I. Performance characteristics of laboratory tests. Clin Chem 46:2027–49.
Edwards, G., & Gross, M. M. (1976). The alcohol dependence: a provisional description of a clinical syndrome. BMJ 1:1058–61.
Edwards, G., Marshall, E. J., & Cook, C. C. H. (2003). The Treatment of Drinking Problems: A Guide for the Helping Professions, 4th edn. Cambridge: Cambridge University Press, chapter 4.
Eustace, L. W., Kang, D. H., Coombs, D., et al. (2003). Fetal alcohol syndrome: a growing concern for health care professionals. J Obstet Gynecol Neonatal Nurs 32:215–21.
Ewing, J. A. (1984). Detecting alcoholism: the CAGE questionnaire. JAMA 252:1905–97.
Feinman, J. A., & Dunner, D. L. (1996). The effect of alcohol and substance abuse on the course of bipolar affective disorder. J Affect Disord 37:43–9.
Finlayson, N., Hayes, P., Simpson, K., et al. (2000). Diseases of the liver and biliary system. In C. Haslett, E. R. Chilvers, J. A. A. Hunter, & N. A. Boon, eds. Davidson's Principles and Practice of Medicine. London: Churchill Livingstone.
Gabriel, S., Grossmann, A., Hoppner, J., et al. (1999). Marchiafava-Bignami syndrome. Extrapontine myelinolysis in chronic alcoholism. Nervenarzt 70:349–56.
Gaziano, J. M., Gaziano, T. A., Glynn, R. J., et al. (2000). Light-to-moderate alcohol consumption and mortality in the Physicians' Health Study enrollment cohort. J Am Coll Cardiol 35:96–105.
Goldberg, J. F., Garno, J. L., Leon, A. C., et al. (1999). A history of substance abuse complicates remission from acute mania in bipolar disorder. J Clin Psychiatry, 58:18–21.
Goodwin, D. W., Schulsinger, F., Hermansen, L., et al. (1973). Alcohol problems in adoptees raised apart from alcoholic biological parents. Arch Gen Psychiatry 28:238–43.
Goodwin, D. W., Schulsinger, F., Moller, N., et al. (1974). Drinking problems in adopted and nonadopted sons of alcoholics. Arch Gen Psychiatry 31:164–9.
Gottheil, E., Murphy, B. F., Skoloda, T. E., et al. (1972). Fixed interval drinking decisions. Q J Stud Alcohol 33:325–40.
Gurling, H. M. D., Clifford, C. A., Murray, R. M., et al. (1981). Investigations into the genetics of alcohol dependence, and into its effects on brain function. In L. Gedda, P. Parisi, & W. E. Nance, eds. Twin Research 3: Epidemiological and Clinical Studies. New York: Alan Liss.
Harper, C., Dixon, G., Sheedy, D., et al. (2003). Neuropathological alterations in alcoholic brains. Studies arising from the New South Wales Tissue Resource Centre. Prog Neuropsychopharmacol Biol Psychiatry 27:951–61.
Harper, C. G., Giles, M., Finlay-Jones, R., et al. (1986). Clinical signs in the Wernicke-Korsakoff complex: a retrospective analysis of 131 cases diagnosed at necropsy. J Neurol Neurosurg Psychiatry 49:341–5.
Hasin, D. S., Grant, B. F., Harford, T. C., et al. (1988). The drug dependence syndrome and related disabilities. Br J Addict 83:45–55.
Hawkins, J. D., Catalano, R. F., Miller, J. Y., et al. (1992). Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: implications for substance abuse prevention. Psychol Bull 112:64–105.
Head, J., Stansfeld, S. A., Seigrist, J., et al. (2004). The psychosocial work environment and alcohol dependence: a prospective study. Occup Environ Med 61:219–24.
Heather, N., Peters, T. J., & Stockwell, T., eds. (2001). The International Handbook of Alcohol Dependence and Problems. Chichester: Wiley.
Heather, N., & Robertson, I. (1997). Problem Drinking – The New Approach, 3rd edn. Oxford: Oxford University Press.
Hibbell, B., Anderson, B., Bjarnason, T., et al. (1999). Alcohol and Other Drug Use Among Students in 30 European Countries (the 1999 ESPAD Report). Stockholm: Council for Information on Alcohol and Other Drugs, Council for Europe, Pompidou Group.
Higgins, E., & du Vivier, A. (1999). Alcohol intake and other skin disorders. Clin Dermatol 17:437–41.
Higgins, E. M., & du Vivier, A. W. (1992). Alcohol and the skin. Alcohol Alcohol 27:595–602.
Hill, S. Y., & Yuan, H. (1999). Familial density of alcoholism and onset of adolescent drinking. J Stud Alcohol 60:7–17.
Hirschi, T. (1969). Causes of Delinquency. Berkeley: University of California Press.
Holmes, S. J., & Robins, L. N. (1987). The influence of childhood disciplinary experience on the development of alcoholism and depression. J Child Psychol Psychiatry 28:399–415.
Hulse, G. K., & Tait, R. J. (2002). Six month outcomes associated with a brief alcohol intervention for adult inpatients with psychiatric disorders. Drug Alcohol Rev 21:105–12.
Jeffrey, D. P., Ley, J., McLaren, S., et al. (2002). Psychosocial treatment programmes for people with both severe mental illness and substance misuse (Cochrane review). The Cochrane Library, 2.
Jernigan, D. H., Monteiro, M., Room, R., et al. (2000). Towards a global alcohol policy: alcohol, public health and the role of WHO. Bull World Health Organ 78:491–9.
Joseph, J. (2002). Twin studies in psychiatry and psychology: science or pseudoscience? Psychiatr Q 73:71–82.
Kaij, L. (1960). Alcoholism in Twins. Stockholm: Almqvist & Wiksell.
Kandel, D. B. (1985). On processes of peer influences in adolescent drug use: a developmental perspective. Adv Alcohol Subst Abuse 4:139–63.
Kendler, K. S., Heath, A. C., Neale, M. C., et al. (1992). A population-based twin study of alcoholism in women. JAMA 268:1877–82.
Khan, S., Murray, R. P., Barnes, G. E., et al. (2002). A structural equation model of the effect of poverty and unemployment on alcohol abuse. Addict Behav 27:405–23.
Khantzian, E. J. (1990). Self-regulation and self-medication factors in alcoholism and the addictions. Similarities and differences. Recent Dev Alcohol 8:255–71.
Khantzian, E. J. (1997). The self-medication hypothesis of substance use disorders: a reconsideration and recent applications. Harv Rev Psychiatry 4:231–44.
Koskenvuo, M., Langinvainio, H., Kaprio, J., et al. (1984). Health related psychosocial correlates of neuroticism: a study of adult male twins in Finland. Acta Genet Med Gemellol (Roma) 33:307–20.
Kosten, T. R., Rounsaville, B. J., Babor, T. F., et al. (1987). Substance abuse disorders in the DSM III R: evidence of the dependence syndrome across different psychoactive substances. B J Psychiatry 151, 834–43.
Kucheria, K., Saxena, R., Mohan, D., et al. (1985). Semen analysis in alcohol dependence syndrome. Andrologia 17:558–63.
Lingford-Hughes, A. R., Welch, S., & Nutt, D. J. (2004). Evidence based guidelines for the pharmacological management of substance misuse, addiction and comorbidity: recommendations from the British Association for Psychopharmacology. J Psychopharmacol 18:293–335.
Lishman, W. (1987). Organic Psychiatry: The Psychological Consequences of Cerebral Disorder. Oxford: Blackwell Scientific.
Lishman, W. A. (1990). Alcohol and the brain. Br J Psychiatry 156:635–44.
Lowman, C., Hunt, W. A., Litten, R. Z., et al. (2000). Research perspectives on alcohol craving: an overview. Addiction 95(Suppl 2): S45–54.
MacAndrew, C., & Edgerton, R. (1969). Drunken comportment: A Social Explanation. Chicago: Aldine.
Marinelli, D., Gaspari, L., Pedotti, P., et al. (2004). Mini-review of studies on the effect of smoking and drinking habits on semen parameters. Int J Hyg Environ Health 207:185–92.
McLellan, A. T., Luborsky, L., Woody, G. E., et al. (1980). An improved diagnostic evaluation instrument for substance abuse patients: the Addiction Severity Index. J Nerv Ment Dis 168:26–33.
Mello, N. K., & Mendelson, J. H. (1965). Operant analysis of drinking patterns of chronic alcoholics. Nature 206:43–6.
Miller, W. R., Brown, J. M., Simpson, T. L., et al. (1995). What works? a methodological analysis of the alcohol treatment outcome literature. In R. K. Hester & W. R. Miller, eds. Handbook of Alcoholism Treatment Approaches: Effective Alternatives. Boston, Massachusetts: Allyn & Bacon, pp. 12–44.
Miller, W. R., & Wilbourne, P. L. (2002). Mesa Grande: a methodological analysis of clinical trials of treatments for alcohol use disorders. Addiction 97:265–77.
Moyer, A., Finney, J. W., Swearingen, C. E., et al. (2002). Brief interventions for alcohol problems: a meta-analytic review of controlled investigations in treatment-seeking and non-treatment-seeking populations. Addiction 97:279–92.
Newlin, D. B., Miles, D. R., van den Bree, M. B., et al. (2000). Environmental transmission of DSM-IV substance use disorders in adoptive and step families. Alcohol Clin Exp Res 24:1785–94.
Noble, E. P. (1996). Alcoholism and the dopaminergic system: a review. Addict Biol 1:333–48.
Nunes, E., & Levin, F. (2004). Treatment of depression in patients with alcohol or other drug dependence: a meta-analysis. JAMA 291:1887–96.
Nurnberger, J. I., Jr., Wiegand, R., Bucholz, K., et al. (2004). A family study of alcohol dependence: coaggregation of multiple disorders in relatives of alcohol-dependent probands. Arch Gen Psychiatry 61:1246–56.
Ogden, E. J., & Moskowitz, H. (2004). Effects of alcohol and other drugs on driver performance. Traffic Inj Prev 5:185–98.
Osier, M. V., Pakstis, A. J., Soodyall, J., et al. (2002). A global perspective on genetic variation at the ADH genes reveals unusual patterns of linkage disequilibrium and diversity. Am J Hum Genet 71:84–99.
Paredes, A., Hood, W. R., Seymour, H., et al. (1973). Loss of control in alcoholism: an investigation of the hypothesis, with experimental findings. Q J Stud Alcohol 34:1146–61.
Parish, L. C., & Fine, E. (1985). Alcoholism and skin disease. Int J Dermatol 24:300–1.
Paschall, M. J., Flewelling, R. L., Russell, T., et al. (2004). Why is work intensity associated with heavy alcohol use among adolescents? J Adolesc Health 34:79–87.
Pickens, R. W., Svikis, D. S., McGue, M., et al. (1991). Heterogeneity in the inheritance of alcoholism. A study of male and female twins. Arch Gen Psychiatry 48:19–28.
Plant, M. A. (1979). Occupations, drinking patterns and alcohol-related problems: conclusions from a follow-up study. Br J Addict Alcohol Other Drugs 74:267–73.
Poschl, G., & Seitz, H. K. (2004). Alcohol and cancer. Alcohol Alcohol 39:155–65.
Poschl, G., Stickel, F., Wang, X. D., et al. (2004). Alcohol and cancer: genetic and nutritional aspects. Proc Nutr Soc 63:65–71.
Preedy, V. R., Ohlendieck, K., Adachi, J., et al. (2003). The importance of alcohol-induced muscle disease. J Muscle Res Cell Motil 24:55–63.
Prescott, C. (2003). Sex differences in the genetic risk for alcoholism [on-line]. National Institute on Alcohol Abuse and Alcoholism. Available at
The Prime Minister's Strategy Unit (2003). Alcohol Project: Interim Analytical Report. London: Cabinet Office.
Prochaska, J. O., & DiClemente, C. C. (1984). The Transtheoretical Approach: Crossing the Traditional Boundaries of Therapy. Homewood: Dow Jones/Irwin.
Raistrick, D. (2001). Alcohol withdrawal and detoxification. In N. Heather, T. J. Peters and T. Stockwell, eds. International Handbook of Alcohol Dependence and Problems. Chichester: Wiley.
Raistrick, D., Bradshaw, J., Tober, G., et al. (1994). Development of the Leeds Dependence Questionnaire (LDQ): a questionnaire to measure alcohol and opiate dependence in the context of a treatment evaluation package. Addiction 89:563–572.
Raistrick, D., Dunbar, G., & Robinson, D. (1983). Development of a questionnaire to measure alcohol dependence. Br J Addict 78:98–95.
Rambaldi, A., & Gluud, C. (2002). Propylthiouracil for alcoholic liver disease. Cochrane Database Syst Rev: CD002800.
Raw, M., McNeill, A., & West, R. (1998). Smoking cessation guidelines for health professionals: a guide to effective smoking cessation interventions for the health care system. Thorax 53(Suppl. 5):S1–S37.
Regier, D. A., Farmer, M. E., Rae, D. S., et al. (1990). Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study. JAMA 264:2511–18.
Ries, R. K., Russo, J., Wingerson, D., et al. (2000). Shorter hospital stays and more rapid improvement among patients with schizophrenia and substance use disorder. Psychiatr Serv 51:210–15.
Romberger, D. J., & Grant, K. (2004). Alcohol consumption and smoking status: the role of smoking cessation. Biomed Pharmacother 58:77–83.
Room, R. (2001). Intoxication and bad behaviour: understanding cultural differences in the link. Soc Sci Med 53:189–98.
Rounsaville, B. J., Bryant, K., Babor, T., et al. (1993). Cross-system agreement for substance use disorders: DSM-III-R, DSM-IV, and ICD-10. Addiction 88:337–48.
Ruhm, C. J., & Black, W. E. (2002). Does drinking really decrease in bad times? J Health Econ 21:659–78.
Rush, B. (1790). An Inquiry into the Effects of Ardent Spirits on the Human Body and Mind, with an Account of the Means for Preventing and of the Remedies for Curing Them (8th edn., 1814). Brookfields: E. Merriam. Reprinted in Q J Stud Alcohol 4:325–41.
Saitz, R., Harlon, N. J., Larson, M. J., et al. (2005). Primary medical care and reductions in addiction severity: a prospective cohort study. Addiction 100:70–8.
Saunders, J. B., Aasland, O. G., Babor, T. F., et al. (1993). Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption II. Addiction, 88:791–804.
Schuckit, M. A., & Smith, T. L. (1997). Assessing the risk for alcoholism among sons of alcoholics. J Stud Alcohol 58:141–5.
Schuckit, M. A., & Smith, T. L. (2001). Correlates of unpredicted outcomes in sons of alcoholics and controls. J Stud Alcohol 62:477–85.
Selzer, M. L. (1971). The Michigan Alcoholism Screening Test: the quest for a new diagnostic instrument. Am J Psychiatry 127:1653–8.
Sesso, H. D. (2001). Alcohol and cardiovascular health: recent findings. Am J Cardiovasc Drugs 1:167–72.
Shand, F., Gates, J., Fawcett, J., & Mattick, R. (2003). The Treatment of Alcohol Problems: A Review of the Evidence. Australia: National Drug and Alcohol Research Centre, Department of Health and Ageing.
Shibuya, A., & Yoshida, A. (1988). Frequency of the atypical aldehyde dehydrogenase-2 gene (ALDH2(2)) in Japanese and Caucasians. Am J Hum Genet 43:741–3.
Sigvardsson, S., Bohman, M., et al. (1996). Replication of the Stockholm Adoption Study of alcoholism. Confirmatory cross-fostering analysis. Arch Gen Psychiatry 53:681–7.
Skinner, H. A., & Allen, B. A. (1983). Differential assessment of alcoholism: evaluation of the alcohol use inventory. J Stud Alcohol 44:852–62.
Skinner, H. A., & Allen, B. A. (1982). Alcohol dependence syndrome: measurement and validation. J Abnorm Psychol 91:199–209.
Skinner, H. A., & Horn, J. L. (1984). Alcohol Dependence Scale: User's Guide. Toronto: Addiction Research Foundation.
Slap, G., Goodman, E., et al. (2001). Adoption as a risk factor for attempted suicide during adolescence. Pediatrics 108:E30.
Slattery, J., Chick, J., Cochrane, M., et al. (2003). Prevention of relapse in alcohol dependence (Health Technology Assessment Report 3). Glasgow: Health Technology Board for Scotland.
Stockwell, T. R., Hodgson, R. J., Rankin, H. J., et al. (1979). The development of a questionnaire to measure severity of alcohol dependence. Br J Addiction 74:79–87.
Stockwell, T., Murphy, D., & Hodgson, R. (1983). The Severity of Alcohol Dependence Questionnaire: its use, reliability and validity. Br J Addiction 78:145–55.
Sullivan, J. T., & K. Sykora, et al. (1989). Assessment of alcohol withdrawal: the revised clinical institute withdrawal assessment for alcohol scale (CIWA-Ar). Br J Addict 84:1353–7.
Svensson, R. (2003). Gender differences in adolescent drug use: the impact of parental monitoring and peer deviance. Youth Soc 34:300–29.
Thom, B., & Tellez, C. (1986). A difficult business: detecting and managing alcohol problems in general practice. Br J Addiction 81:405–18.
Thomson, A. D., C. C. Cook, et al. (2002). The Royal College of Physicians report on alcohol: guidelines for managing Wernicke's encephalopathy in the accident and Emergency Department. Alcohol Alcohol 37:513–21.
Tome, S., & Lucey, M. R. (2004). Review article: current management of alcoholic liver disease. Aliment Pharmacol Ther 19:707–14.
Trotter, T. (1804). An Essay, Medical, Philosophical and Chemical, on Drunkenness, and Its Effects on the Human Body. London: T. N. Longman & G. Rees. Facsimile reproduction 1988 with an introduction by Roy Porter. London: Routledge.
Turner, R. T. (2000). Skeletal response to alcohol. Alcohol Clin Exp Res 24:1693–1701.
Turner, R. T., & Sibonga, J. D. (2001). Effects of alcohol use and estrogen on bone. Alcohol Res Health 25:276–81.
Vaillant, G. E. (1983). The Natural History of Alcoholism. Cambridge, Massachusetts: Harvard University Press.
Velleman, R., & Orford, J. (1993). The adult adjustment of offspring of parents with drinking problems. Br J Psychiatry 162:503–16.
Viola, A., Nicoli, F., et al. (2001). Applications of magnetic resonance spectrometry (MRS) in the study of metabolic disturbances affecting the brain in alcoholism. Pathol Biol (Paris) 49:718–25.
Walters, G. D. (2002). The heritability of alcohol abuse and dependence: a meta-analysis of behavior genetic research. Am J Drug Alcohol Abuse 28:557–84.
Whitfield, J. B., Zhu, G., et al. (2004). The genetics of alcohol intake and of alcohol dependence. Alcohol Clin Exp Res 28:1153–60.
Wilk, A. I., Jensen, N. M. & Havighurst, T. C. (1997). Meta-analysis of randomized controlled trials addressing brief interventions in heavy alcohol drinkers. J Gen Int Med 12:274–83.
Windle, M. (1977). Effect of parental drinking on adolescents. Research in Brief. Buffalo, New York: Research Institute on Addictions.
World Health Organisation (2004). Global Status Report on Alcohol Policy. Geneva: World Health Organisation.
World Health Organisation (1992). ICD–10 Classification of Mental and Behavioural Disorders. Geneva: World Health Organisation.
World Health Organisation (1952). Expert Committee on Mental Health, Alcoholism Subcommittee, Second Report (WHO Technical Report Series No. 48). Geneva: World Health Organisation.
Yoshida, A., Huang, I. Y., Ikawa, M., et al. (1984). Molecular abnormality of an inactive aldehyde dehydrogenase variant commonly found in Orientals. Proc Natl Acad Sci U S A 81:258–61.
Zimberg, S. (1993). Introduction and general concepts of dual diagnosis. In J. Solomon, S. Zimberg & E. Shollar, eds. Dual Diagnosis – Evaluation, Treatment, Training and Program Development. New York: Plenum.