The Typology of Alcohol Use Disorder: Latent Class Analyses of a Population-Based Swedish Sample

Objective: The purpose of this study was to clarify the clinical heterogeneity of alcohol use disorder (AUD) in a national Swedish sample of affected individuals using latent class analysis. Method: Using a Swedish population-based sample of AUD cases ascertained from medical, criminal, and pharmacy registries (n = 217,071), we applied latent class analysis to sex, externalizing and internalizing syndromes before first registration, and age at first registration. The re-sulting types were evaluated against 15 diverse validators and degree of resemblance in relative pairs concordant for AUD. Results: A three-class solution was preferred by fit indices. The three classes were as follows: type 1 (male preponderant, externalizing; 32%), type 2 (minimal prior psychopathology; 46%), and type 3 (mixed-sex internalizing; 23%). Repeated split-half analyses revealed the statistical stability of these solutions. Meaningful differences emerged between the classes on many validators. Type 1 had the greatest family disruption, lowest educational levels, most AUD registrations, highest rates of criminal registration, and highest genetic risk for externalizing disorders and AUD. Type 2 had the least social dysfunction. Type 3 had the highest educational attainment, genetic liability to internalizing disorders, and proportion of women. All types significantly aggregated in affected pairs of relatives. Conclu-sions: Meaningful and reproducible subtypes of AUD, consistent with prior typological results, can be obtained from national registry–based samples. Using a range of external validators and patterns of familial aggregation, our results suggest that our three-class solution captured a meaningful proportion of the clinical heterogeneity of AUD.