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Saturday, January 22, 2011

Chapter 91 The Alcohol Drinking History

Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition.
Walker HK, Hall WD, Hurst JW, editors.
Boston: Butterworths; 1990.
The American Psychiatric Association (DSM-III, 1980) has defined alcoholism and alcohol abuse as follows: alcoholism (or alcohol dependence) is "either a pattern of pathological alcohol use or impairment in social or occupational functioning due to alcohol, and either tolerance or withdrawal." A simplified interpretation of this definition is presented in Figure 91.1. Alcohol abuse is defined as "a pattern of pathological use for at least a month that causes impairment in social and occupational functioning." Few definitions in medicine have incited as much discussion as that of "alcoholism," mainly because excessive drinking may manifest as a medical problem (e.g., withdrawal seizures), a psychiatric problem (e.g., depression), or a social problem (e.g., involvement in an automobile accident). On the other hand, a person with a single episode of an alcohol-related problem is not necessarily an alcoholic; in such a case, the condition may be better termed "alcohol abuse."
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