THE HISTORIES OF WITHDRAWAL CONVULSIONS AND DELIRIUM-TREMENS IN 1648 ALCOHOL-DEPENDENT SUBJECTS

A small proportion of alcohol-dependent men and women experience delir ium tremens (DTs) and/or convulsions during alcohol withdrawal. While some characteristics of individuals most likely to show these severe s equelae of the abstinence syndrome have been described, it is not clea r whether these risk factors operate independently in their associatio n with severe withdrawal. The Semi-Structured Assessment for the Genet ics of Alcoholism (SSAGA) interview was used to evaluate 1648 alcohol dependent men and women (including 540 women). The background characte ristics and drinking histories of the 160 men and 51 women (12.8% of t he subjects) who reported ever having had at least one episode of DTs and/or convulsions during withdrawal were compared with the characteri stics of the remaining alcohol dependent individuals. Compared to othe r alcohol-dependent subjects, those with histories of severe withdrawa l reported a greater maximum number of drink in any 24-hour period (40 .9 +/- 25.71 versus 24.9 +/- 17.72), more withdrawal episodes (28.2 +/ - 33.74 versus 15.9 +/- 26.84), more non-medicinal use of sedative-hyp notics (56.4% versus 32.9%) and a greater number of medical problems. Hierarchical logistic regression analysis revealed that the most power ful differences between those with histories of more and less severe w ithdrawals related to the maximum number of drinks per day and the tot al number of withdrawal episodes. The remaining variables still added significantly to the relationship to more severe withdrawal. The etiol ogy of DTs and convulsions is complex and involves the interaction of diverse characteristics representing relatively unique domains. It is hoped that these data will help clinicians identify individuals most l ikely to have experienced severe withdrawal syndromes and will aid res earchers attempting to understand more about the etiology of these pro blems.