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Thursday, May 31, 2012

CORRESPONDENCE “The Evil Genius of the Habit”: DSM-5 Seen in Historical Context





Dear Editor:
In 1804, Thomas Trotter published a founding text on alcohol problems (Trotter, 1804). His advice to physicians was that it would inevitably be of no avail to treat a drinker’s gout, gastritis, or any other of the then-recognized alcoholrelated disorders if the practitioner failed to deal with what he termed “the evil genius of the habit” (p. 178). Trotter used that evocative phrase to identify a syndrome, the elements of which he detailed. He saw “habit” as the pathological basis
for the recognizable clinical entity that he designated as “a disease of the mind” (p. 179). He did not, however, introduce any new terminology for this condition, but rested content ith “the habit of drunkenness” (p. 181). The quest to find a name for Trotter’s syndrome, and the status to be given it, continues to this day, most recently with the debate provoked by the proposed handling of the topic in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition(DSM-5) (Addiction, Vol. 106, pp. 866–897). This letter
will attempt to give current concerns their historical context before commenting on the present situation. > > > > Read More