You are assessing a patient with a history of a sudden, violent episode after drinking. Which single piece of information is most important to establish to support or rule out pathological drunkenness?
Establishing the actual quantity consumed against the severity of the resulting behaviour, and whether the usual physical signs of drunkenness were present or notably absent, directly tests the defining, disproportionate pattern the phenomenon's own text describes. General drinking history, the specific drink type, and sober violence history are less directly diagnostic of this specific pattern.
Key discriminating feature: The defining feature of pathological drunkenness is a striking disproportion between a small quantity of alcohol and severe violence, combined with the absence of usual drunkenness signs, so establishing both of these directly is essential.
References
- Casey, P. & Kelly, B. (2019). Fish's Clinical Psychopathology, 4th ed. Ch. 8, 'Motor Disorders'.