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As chairman of the Criteria Committee of the National Council on Alcoholism, I am gratified that Drs. Ringer, Kiifner, Antons and Feuerlein undertook the difficult task of evaluating the utility of the N.C.A. criteria in their painstaking and practical study (1). The criteria evolved from the input of 65 experts on alcoholism, an exhaustive review of the literature on diagnosis, and the critical review of the N.C.A. Committee. As with any such assemblage of empirical material, only testing in actual populations can evaluate its utility and help tease out the items which correlate best with positive cases yet do not misdiagnose nonalcoholics. In this evaluation, the authors report that the criteria correctly identified all the known alcoholics but also diagnosed 47.5% of the "controls" as alcoholics. They found that 38 of the 86 criteria did not contribute to discrimination between alcoholics and controls. Employing only the sum of the remaining 48 items, 957o of the subjects were classified correctly. The accuracy could be increased to 997o by using only the 17 criteria which have a minimum correlation (r: .5) with the independent criterion. The cause of the high percentage of controls diagnosed as alcoholics may be in the nature of the controls. These were 80 male inpatients (in a general hospital) who were not "suspected" of being alcoholics. As the authors explain, the attending physicians usually did not have much training in psychiatry, and many alcoholics are overlooked in routine clinical examinations-indeed, this is one reason diagnostic riteria are needed. In an American general hospital, perhaps 20o• of the adult male patients can be expected to be alcoholics. It is quite probable that many of the controls were accurately diagnosed by use of the criteria.

Chlordiazepoxide, paraldehyde, perphenazine and sodium pentobarbital all produced similarly favorable results in the treatment of uncomplicated delirium tremens. Drugs that are cross-dependent with...

The treatment of alcoholism depends on the phase of the disease which the physician is called on to treat: acute intoxication, acute withdrawal, or chronic alcoholism. When should anti-anxiety drugs be used? Almost never for intoxication, almost always during withdrawal, and sometimes during the treatment of chronic alcoholism.

A double-blind study of 537 patients evaluated the relative efficacy of four drugs—chlordiazepoxide, chlorpromazine, hydroxyzine, and thiamine—commonly used in treating alcohol withdrawal symptoms, specifically to prevent delirium tremens and convulsions. Of the 55 patients who developed these symptoms, two percent were in the chlordiazepoxide group; the incidence ranged from ten to 16 percent in the other treatment groups. The authors conclude that chlordiazepoxide appears to be the drug of choice among those tested.