The term dependence has diverse implications. As the outward appearanc
e of alcohol dependent patients is changing, the process of defining a
lcohol dependence is steadily in evolution. The heterogeneity of clini
cal syndroms is caused by cultural factors including doctor-patient-re
lationship and by influence of co-resp. multimorbidity of alcohol sequ
els. Future research has to implement relapse patterns as course modif
ying factor of dependence syndromes.