Towards an integrated clinical psychobiology of alcoholism

Alcohol dependency is a complex multi-factorial clinical presentation characterized by etiological ambiguity, poor treatment adherence and unfavorable prognosis. Recent evidence suggest considerable heterogeneity in this patient group across a number of neurological, genetic, psychological and personality parameters which relate directly to the clinical manifestation and course of this chronic condition. The current review examines contemporary cross-disciplinary research reports to present an integrated psychobiological synthesis of the main themes. The psychobiological model proposed offers a template for both clinicians and researchers to evaluate the relative contribution of key indicators to the end-point gestalt of alcohol dependency. Analysis and integration of psychobiological risk factors are illuminated within the context of sub-type identification, tailored treatment interventions and clinical outcome prediction. Implications for current psychiatric practice and the direction of future research are discussed.