Studies in treatment and population samples have confirmed that alcoholic subtypes marked by psychopathology are more severely dependent. Epstein et al.(2002) found that Type B alcoholic patients, with higher rates of psychopathology as per Babor et al. (1992), consumed more alcohol, had higher dependence screening scores and had more medical, physical and social consequences than Type A patients. Windle and Scheidt (2004) reported increased levels of consumption, physical and social consequences and lifetime severity in subtypes characterized by externalizing and internalizing psychopathology. In another treatment sample, the odds of poor psychological quality of life at intake were more than quadrupled by psychiatric comorbidity, independent of severity of dependence (Lahmek et al., 2009). In the general population, Moss et al. (2007) reported the highest levels of consumption in the young antisocial and severe chronic alcoholic subtypes. Both subtypes were characterized by high levels of externalizing disorder, the latter also by high levels of internalizing disorder. In another general population sample, Carpenter and Hasin (2001) reported higher levels of consumption, severity, treatment utilization and dependence among Dionysian than Apollonian problem drinkers, with the former characterized by higher levels of psychopathology, especially externalizing.
