SYMPTOM HETEROGENEITY IN COMORBID ALCOHOL DISORDER

The heterogeneity of signs and symptoms of alcohol disorder was examin ed in a community sample of 1,955 persons with either alcohol disorder alone or alcohol disorder plus one of four categories of major mental disorder (antisocial personality disorder; schizophrenia, affective d isorder anxiety disorder). When all diagnostic categories were combine d, persons with comorbid mental and alcohol disorders showed evidence of more severe alcohol-related symptoms than did persons with alcohol disorder alone. Distinct symptom patterns distinguished the four diagn ostic groups, reflecting heterogeneity in the manifestation of comorbi d alcohol disorder Most notably comorbid antisocial personality disord er and schizophrenia were associated with higher levels of alcohol con sumption and more severe social consequences of alcohol use. These fin dings substantiate the need for development of specialized dual diagno sis programs and suggest that additional specialization may be require d to address diagnostic group differences in the characteristics of co morbid alcohol disorder.