Psychiatric study of the chronic drunkenness offender.

Abstract

Pychiatric investigations in a series of 237 chrónic drunkenness offenders (persons who have had repeated convictions for drunkenness in a public place) revealed psychopathology and psychiatric and social disorders in virtually all of the subjects. Half of the subjects were diagnosed as passive aggressive personalities, schizoid personalities or presenting schizophrenic reactions, having in common a high degree of emotional vulnerability, dependence, inability to give rather than take, inability to assume responsibilities society imposes on the adult and a tendency to withdraw under increased stress. Similar features are present, underlying or associated with depression, in those diagnostic categories in which the depressive element plays a significant part—depressive reactions, manic-depressive reactions, cyclothymic personalities and emotionally unstable personalities. Based on Freud's ideas on civilization and its discontent, the chronic Skid Row alcoholic (who is liable to become a chronic drunkenness offender) is regarded as an individual whose passivity interferes to the highest degree with an adequate response to the frustrating experiences caused by the restrictions on the sex drive and the expression of aggression imposed by civilization. He is using two devices, intoxication and isolation, in his attempts to deal with his emotional and social predicament. These processes are facilitated by the conditions of his social level which makes these modes of adaptation more accessible than others. The nature of the ‘offence' and problems concerning prognosis and management are discussed.