Clinical and temperamental differences between early- and late-onset alcoholism in Korean men

Objectives: The aims of this study were to elucidate the clinical and temperamental differences between early- and late-onset alcoholism among Korean men and to ascertain the validity of Cloninger's typology model of alcoholism for Koreans. Methods: All of the subjects were screened after a detoxification period of at least 2 weeks using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I Disorders for diagnosing alcohol dependence and identifying psychiatric comorbidities. The Korean version of the tridimensional personality questionnaire was then administered to 173 male alcoholic inpatients; and information regarding their criminality, family history of alcoholism, and age at the onset of alcohol-related problems was gathered. We divided the patients into 2 groups based on the age at the onset of alcoholism: (1) early onset (n = 80), when they were up to 25 years old at the onset, and (2) late onset (n = 93), when they were older than 25 years at the onset. Results: Early-onset patients exhibited more criminality (χ² = 15.45, df = 1, P < .001, odds ratio [OR] = 3.84, 95% confidence interval [CI] = 1.93-7.65), suicide attempts (χ² = 7.92, df = 1, P = .005, OR [95% CI] = 3.14 [1.38-7.15]), and family history of alcoholism (χ² = 24.75, df = 1, P < .001, OR [95% CI] = 5.27 [2.67-10.37]). With regard to the tridimensional personality questionnaire profile, the early-onset patients exhibited a higher score of novelty seeking (t = 3.42, P = .001), with the difference still being significant after adjusting for age by analysis of covariance (using age as a covariate) (F = 5.928, P = .016). However, harm avoidance (t = -0.13, P = .89), reward dependence (t = -0.19, P = .85), and persistence (t = -0.62, P = .54) did not differ between the 2 groups. Conclusions: There were several distinct clinical and temperamental differences between early- and late-onset alcoholism among Korean male alcoholic patients. It is suggested that the age at the onset of alcoholism can be used to discriminate alcoholic subtypes. Our data also partly support Cloninger's typology of 2 types of alcoholic individuals.