Mood Emot 2019 Jul; 17(2): 49-56  
Comparison of Psychological Characteristics of Lesch Types 2 (Anxiety Model) and 3 (Depressive Model) Alcoholism
Sae Heon Jang, MD, Min Ho Chang, MD, Young Myo Jae, MD, PhD, Jin Hyuk Choi, MD, Gyeong Hwan Lee, MD
Department of Psychiatry, Bong Seng Memorial Hospital, Busan, Korea
Correspondence to: Sae Heon Jang, MD
Department of Psychiatry, Bongseng Memorial Hospital, 401 Jungang-daero, Dong-gu, Busan 48775, Korea
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Received: May 13, 2019; Revised: June 20, 2109; Accepted: July 2, 2019; Published online: July 31, 2019.
© Korean Society for Affective Disorders. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Lesch types 2 (L2, anxiety model) and 3 (L3, depressive model) of alcoholism exhibit different responses to anti-craving agents, and most treatment guidelines provide differential treatment strategies for bipolar depression (DEP) and unipolar DEP. We compare the psychological characteristics of L2 and L3 alcoholism and between the unipolar and bipolar subgroups.
Methods: We reviewed medical records of patients who were diagnosed with alcohol use disorder using the DSM5 diagnostic criteria and classified as L2 and L3 using Lesch Alcohol typology software. All patients completed selfreport scales (Alcohol Use Disorders Identification Test [AUDIT], Beck Anxiety Inventory [BAI], Beck Depression Inventory-II [BDI-II], and Korean Symptom Checklist-95 [KSCL95]). The data were analyzed using descriptive statistics, the Wilcoxon Rank-Sum test, and ANOVA.
Results: Of the 43 patients, 23 were assigned L2, and 20 were assigned L3. The scores for the KSCL95 subscales fell generally in the increasing order of the L2-unipolar (L2U, n=10), L2-bipolar (L2B, n=13), L3-unipolar (L3U, n=11), and L3-bipolar (L3B, n=9) types. The L3B scores were greater than the L3U scores for most KSCL95 subscales, by contrast with the DEP and BAI scores.
Conclusion: We found psychological differences between L2 and L3 and identified the unique psychological characteristics for each subgroup by polarity. The psychological characteristics of these subgroups of alcohol use disorder may help improve the treatment success rates through individualized treatment strategies.
Keywords: Lesch’s typology; Alcohol use disorder; Unipolar depression; Bipolar depression
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