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Severe alcohol withdrawal syndrome: review of the literature

George Benson (NHS Greater Glasgow and Clyde, Paisley, UK)
Nicola Roberts (Department of Health and Life Science, Glasgow Caledonian University, Glasgow, UK)
Jacqueline McCallum (Department of Health and Life Science, Glasgow Caledonian University, Glasgow, UK)
Andrew McPherson (Department of Addictions, NHS Greater Glasgow and Clyde, Paisley, UK)

Drugs and Alcohol Today

ISSN: 1745-9265

Article publication date: 7 January 2019

Issue publication date: 23 October 2019




The purpose of this paper is to identify published literature from a general hospital setting that may highlight variables implicated in the development of severe alcohol withdrawal syndrome (SAWS) in patients who have alcohol dependence syndrome (ADS).


A systematic literature review was carried out using the electronic databases: MEDLINE, Medline in Process, Cinahl, Embase and PsycINFO from 1989 to 2017. The focus of this search was on English language studies of individuals over 16 years admitted to general hospital with ADS, delirium tremens (DTs), alcohol-related seizure (ARS) or alcohol withdrawal syndrome (AWS).


Of the 205 studies screened, eight met the criteria for inclusion. Six studies were quantitative retrospective cohort and two were retrospective case-control. Six studies investigated risk factors associated with DTs, one examined SAWS and one alcohol kindling. Descriptive analysis was performed to summarise the empirical evidence from studies were 22 statistically significant risk factors were found; including the reason for admission to hospital, daily alcohol consumption, previous DTs and prior ARS. The last two factors mentioned appeared in two studies.

Research limitations/implications

Further research should consider the quality and completeness of the alcohol history data and competence of staff generating the data in retrospective studies.


The paper suggests that the factors linked to SAWS development from the literature may not fully explain why some individuals who have ADS develop SAWS, and others do not.



Since the time of writing this paper George Benson regrettably died.


Benson, G., Roberts, N., McCallum, J. and McPherson, A. (2019), "Severe alcohol withdrawal syndrome: review of the literature", Drugs and Alcohol Today, Vol. 19 No. 4, pp. 306-315.



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