Subtypes of Alcohol Dependence/Alcohol Use Disorder: a systematic review
Background: Variables included in researcher driven AD/AUD typologies are a function of their perceived importance. This systematic review aimed to summarise researcher typologies of AD/AUD.
Methods: Eight databases were searched. Papers included featured adults with an ICD/DSM AD/AUD diagnosis, in an English, peer-reviewed article published from 1990-present, which aimed to create patterns of AD/AUD. Papers excluded included when typologies were a response to treatment, samples with AUD/AD and not, or patterns of a condition (e.g. personality disorder) in an AD/AUD sample. A narrative synthesis of typologies was generated and study quality was appraised using Mixed Methods Appraisal Tool.
Results: In this review, 38 papers, used 18 different criteria to create typologies of AUD/AD. The most commonly used were age of onset or duration of alcohol use (66%) followed by abuse or dependence criteria including number of symptoms and severity (40%). Patterns were most often researcher defined aligned with Babor, Von Knorring, or Cloninger typologies, however, some were empirically derived, most commonly Latent Class Analysis.
Conclusion: Researcher driven typologies vary, often include elements other than AUD/AD symptoms, and may draw upon existing subtypes derived using populations with an abuse diagnosis alongside AD/AUD. We recognise as a limitation the absence of typologies from grey literature. There was little involvement of those with AD/AUD lived experience in the typologies, and as such, typologies may inadvertently stigmatise those with AD/AUD or missed out on relevant factors they might prioritise. We recommend involving those with AD/AUD lived experience in representations of their condition.