Comparison of DSM-IV and DSM-5 criteria for alcohol use disorders in VA primary care patients with frequent heavy drinking enrolled in a trial

Traci Takahashi, Gwen Lapham, Laura J Chavez, Amy K Lee, Emily C Williams, Julie E Richards, Diane Greenberg, Anna Rubinsky, Douglas Berger, Eric J Hawkins, Joseph O Merrill, Katharine A Bradley, Traci Takahashi, Gwen Lapham, Laura J Chavez, Amy K Lee, Emily C Williams, Julie E Richards, Diane Greenberg, Anna Rubinsky, Douglas Berger, Eric J Hawkins, Joseph O Merrill, Katharine A Bradley

Abstract

Background: Criteria for alcohol use disorders (AUD) in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) were intended to result in a similar prevalence of AUD as DSM-IV. We evaluated the prevalence of AUD using DSM-5 and DSM-IV criteria, and compared characteristics of patients who met criteria for: neither DSM-5 nor DSM-IV AUD, DSM-5 alone, DSM-IV alone, or both, among Veterans Administration (VA) outpatients in the Considering Healthier drinking Options In primary CarE (CHOICE) trial.

Methods: VA primary care patients who reported frequent heavy drinking and enrolled in the CHOICE trial were interviewed at baseline using the DSM-IV Mini International Neuropsychiatric Interview for AUD, as well as questions about socio-demographics, mental health, alcohol craving, and substance use. We compared characteristics across 4 mutually exclusive groups based on DSM-5 and DSM-IV criteria.

Results: Of 304 participants, 13.8% met criteria for neither DSM-5 nor DSM-IV AUD; 12.8% met criteria for DSM-5 alone, and 73.0% met criteria for both DSM-IV and DSM-5. Only 1 patient (0.3%) met criteria for DSM-IV AUD alone. Patients meeting both DSM-5 and DSM-IV criteria had more negative drinking consequences, mental health symptoms and self-reported readiness to change compared with those meeting DSM-5 criteria alone or neither DSM-5 nor DSM-IV criteria.

Conclusions: In this sample of primary care patients with frequent heavy drinking, DSM-5 identified 13% more patients with AUD than DSM-IV. This group had a lower mental health symptom burden and less self-reported readiness to change compared to those meeting criteria for both DSM-IV and DSM-5 AUD. Trial Registration ClinicalTrials.gov NCT01400581. 2011 February 17.

Keywords: Alcohol; Alcohol use disorder; Binge drinking; DSM-5; DSM-IV.

Figures

Fig. 1
Fig. 1
DSM-IV and DSM-5 alcohol use disorder criteria (AUD)

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Source: PubMed

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