The Etiology of Alcoholism in the English Upper Social Classes

Abstract

Twenty alcoholics and 31 other psychiatric patients at a psychiatric hospital in England and 77 control patients from the general medical and surgical wards of a teaching hospital, of the same nationality (English) and sex (male), and of similar age and social class, were compared on certain aspects of occupation, marital status, previous personal and family history and experience in the armed forces. Data from the alcoholics relating to the period and pattern of excessive drinking and factors in its origin and perpetuation were also examined. In 16 of the alcoholics, the onset of excessive drinking was blamed on social custom: 10 in the armed forces, 6 in occupations. Its perpetuation, however, was attributed to stress: marital stress in 8, work stress in 6, and psychiatric stress in 5; only 3 incriminated occupational custom. Alcoholism of late onset or relapse of preexisting excessive drinking was found to be more certainly related to stress. Although not having more military service than the other groups, more of the alcoholics (70 percent) than of the other patients (37 and 39 percent) tended to have achieved senior military rank and more had served in the Navy or Air Force than in the Army. The alcoholics had a history of less mental illness than the nonalcoholic psychiatric patients (30 vs. 50 percent) and had more surviving marital partners (90 vs. 63 percent); 35 percent of the alcoholics and 20 percent of the nonalcoholics had broken marriages. Of the 77 control patients, 14 percent had a history of mental illness. A family history of alcoholism was reported in 20 percent of the alcoholics* and 7 percent of the nonalcoholics; and a family history of mental illness in 20 and 30 percent, respectively. The implications of these findings were discussed.