Familial alcoholism: a separate entity?

Numerous studies indicate that alcoholism runs strongly in families. Recent evidence from twin and adoption studies suggest the illness may have a genetic component. These studies have stimulated two lines of research which are actively being conducted in several centers. One type of research involves comparing alcoholics with a positive family history of alcoholism with alcoholics who lack such a history. The second line of research involves comparing college-age sons of alcoholics with sons of nonalcoholics before members of either group have had an extensive drinking history. Studies consistently show that "familial" alcoholics differ from "nonfamilial" alcoholics in having (a) an earlier age of onset and (b) symptoms of greater severity. Familial alcoholism has also been associated with a childhood history of hyperactivity and conduct disorder and an adult history of antisocial behavior. In one study, familial alcoholics more often showed signs of structural and functional brain abnormalities than did nonfamilial alcoholics. Sons of alcoholics versus controls have been reported to have higher blood acetaldehyde levels after drinking alcohol and also demonstrate more subjective and motor tolerance for alcohol. Sons of alcoholics also generate more alpha activity on the EEG after alcohol and make lower scores on the categories test of the Halstead Battery. About half of hospitalized alcoholics have a family history of alcoholism. Studies indicate that the family-history-positive and family-history-negative alcoholics differ on a number of variables. Twin, adoption and high-risk studies add further evidence that "familial alcoholism" is a separate diagnostic entity.