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Dipsomania is a historical term describing a medical condition involving an uncontrollable craving for alcohol. In the 19th century, the term dipsomania was used to refer to a variety of alcohol-related problems, most of which are known today as alcoholism. Dipsomania is occasionally still used to describe a particular condition of periodic, compulsive bouts of alcohol intake. The idea of dipsomania is important for its historical role in promoting a disease theory of chronic drunkenness. The word comes from Greek "dipso" ("δίψα"= thirst) and "mania".
It is still mentioned in the WHO ICD-10 classification as an alternative description for Alcohol Dependence Syndrome, episodic use F10.26
The term was coined by the German physician C. W. Hufeland in 1819, when, in a preface to an influential book by German-Russian doctor C. von Brühl-Cramer, he translated Brühl-Cramer's term ""trunksucht"" as "dipsomania".
Due to the influence of Brühl-Cramer's pioneering work, dipsomania became popular in medical circles throughout the 19th century. Political scientist Mariana Valverde describes dipsomania as "the most medical" of the many terms used to describe habitual drunkenness in the 19th century. Along with terms such as "inebriety", the idea of dipsomania was used as part of an effort of medical professionals and reformers to change attitudes about habitual drunkenness from being a criminally punishable vice to being a medically treatable disease. As historian Roy MacLeod wrote about this dipsomania reform movement, it "illuminates certain features of the gradual transformation taking place in national attitudes towards the prevention and cure of social illnesses during the last quarter of the 19th century."
Although "dipsomania" was used in a variety of somewhat contradictory ways by different individuals, by the late 19th century the term was usually used to describe a periodic or acute condition, in contrast to chronic drunkenness. In his 1893 book "Clinical Lessons on Mental Diseases: The Mental State of Dipsomania", Magnan characterized dipsomania as a crisis lasting from one day to two weeks, and consisting of a rapid and huge ingestion of alcohol or whatever other strong, excitatory liquid was available. Magnan further described dipsomania as solitary alcohol abuse, with loss of all other interests, and these crises recurred at indeterminate intervals, separated by periods when the subject was generally sober.
Over time, the term dipsomania became less common, replaced by newer ideas and terms concerning chronic and acute drunkenness and alcoholism.
Several tools may be used to detect a loss of control of alcohol use. These tools are mostly self-reports in questionnaire form. Another common theme is a score or tally that sums up the general severity of alcohol use.
The CAGE questionnaire, named for its four questions, is one such example that may be used to screen patients quickly in a doctor's office.
Other tests are sometimes used for the detection of alcohol dependence, such as the Alcohol Dependence Data Questionnaire, which is a more sensitive diagnostic test than the CAGE questionnaire. It helps distinguish a diagnosis of alcohol dependence from one of heavy alcohol use. The Michigan Alcohol Screening Test (MAST) is a screening tool for alcoholism widely used by courts to determine the appropriate sentencing for people convicted of alcohol-related offenses, driving under the influence being the most common. The Alcohol Use Disorders Identification Test (AUDIT), a screening questionnaire developed by the World Health Organization, is unique in that it has been validated in six countries and is used internationally. Like the CAGE questionnaire, it uses a simple set of questions – a high score earning a deeper investigation. The Paddington Alcohol Test (PAT) was designed to screen for alcohol-related problems amongst those attending Accident and Emergency departments. It concords well with the AUDIT questionnaire but is administered in a fifth of the time. Certain blood tests may also indicate possible alcoholism.
There are reliable tests for the actual use of alcohol, one common test being that of blood alcohol content (BAC). These tests do not differentiate alcoholics from non-alcoholics; however, long-term heavy drinking does have a few recognizable effects on the body, including:
- Macrocytosis (enlarged MCV)
- Elevated GGT
- Moderate elevation of AST and ALT and an AST: ALT ratio of 2:1
- High carbohydrate deficient transferrin (CDT)
With regard to alcoholism, BAC is useful to judge alcohol tolerance, which in turn is a sign of alcoholism.
However, none of these blood tests for biological markers is as sensitive as screening questionnaires.