Tipologia de Lesch em alcoolistas no Brasil

Abstract

Objective: Alcohol dependence is a heterogeneous disease with a clear variability in clinical, therapeutic results and relapses, indicating different biological vulnerability. Lesch et al (1988) distinguished four categories of alcohol dependence: Type I - severe symptoms of abstinence; Type II - alcohol as a solution for conflicts; Type III - alcohol as self-medication for psychiatric symptoms; Type IV - history of neurological lesions preceding the development of alcohol dependence. This study examined the applicability of a classification of the clinical type of alcoholism according to Lesch's Typology in a high demanding Brazilian public outpatient service for alcohol dependence. Method: Alcoholics from a Brazilian public outpatient service for treatment of alcoholism of the School of Medicine of the Federal University of Espírito Santo were classified into categories according to Lesch's Typology. Results: Differentiation by Lesch's Typology was easily conducted in a high demanding public outpatient service. Of 170 alcoholics, 21.2% were classified as Type I; 29.4%, Type II; 28.8%, Type III; 20.6%, Type IV. Although different types of alcoholism have different clinical presentations, patients showed similar pattern of alcohol intake, age for the first use of alcohol and withdrawal. Conclusion: Distinguishing clinical types of alcohol dependence according to Lesch's Typology was considered applicable in a high demanding Brazilian public outpatient service, in which the results were similar to those reported in studies realized in other countries. The application of this classification may provide significant changes in strategies for individualized approaches that may be of a great importance in the treatment of alcohol dependence. However, the therapeutic results of these changes will need to be evaluated in follow-up studies.