From the Guidelines
Alcohol Use Disorder (AUD) is diagnosed based on a problematic pattern of alcohol use leading to clinically significant impairment or distress, as manifested by at least two of the 11 diagnostic criteria within a 12-month period.
Diagnostic Criteria for AUD
The diagnostic criteria for AUD, as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), include:
- Alcohol is often taken in larger amounts or over a longer period than was intended
- There is a persistent desire or unsuccessful efforts to cut down or control alcohol use
- A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects
- Craving, or a strong desire or urge to use alcohol
- Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home
- Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol
- Important social, occupational, or recreational activities are given up or reduced because of alcohol use
- Recurrent alcohol use in situations in which it is physically hazardous
- Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol
- Tolerance, as defined by either a need for markedly increased amounts of alcohol to achieve intoxication or desired effect, or a markedly diminished effect with continued use of the same amount of alcohol
- Withdrawal, as manifested by either the characteristic withdrawal syndrome for alcohol, or alcohol (or a closely related substance) is taken to relieve or avoid withdrawal symptoms, as stated in 1.
Severity of AUD
The severity of AUD is defined as:
- Mild: The presence of 2 to 3 criteria
- Moderate: The presence of 4 to 5 criteria
- Severe: The presence of 6 or more criteria, as indicated in 1. The DSM-5 criteria for AUD provide a comprehensive framework for diagnosing and assessing the severity of alcohol use disorder, as discussed in 1.
From the Research
Diagnostic Criteria for Alcohol Use Disorder (AUD)
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) contains a severity gradient based on the number of criteria endorsed for Alcohol Use Disorder (AUD) diagnosis 2. The diagnostic criteria for AUD in DSM-5 include:
- A pattern of alcohol use leading to significant impairment or distress, as manifested by at least two of the following criteria within a 12-month period:
- Alcohol is often taken in larger amounts or over a longer period than was intended
- There is a persistent desire or unsuccessful efforts to cut down or control alcohol use
- A great deal of time is spent in activities necessary to obtain or use alcohol, or to recover from its effects
- Craving, or a strong desire or urge to use alcohol
- Recurrent alcohol use resulting in failure to fulfill major role obligations at work, school, or home
- Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol
- Important social, occupational, or recreational activities are given up or reduced because of alcohol use
- Recurrent alcohol use in situations in which it is physically hazardous
- Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol
- Tolerance, as defined by either a need for markedly increased amounts of alcohol to achieve intoxication or desired effect, or a markedly diminished effect with continued use of the same amount of alcohol
- Withdrawal, as manifested by either the characteristic withdrawal syndrome for alcohol, or the use of alcohol (or a closely related substance) to relieve or avoid withdrawal symptoms
Severity of AUD
The severity of AUD is based on the number of criteria endorsed, with:
- Mild AUD: 2-3 criteria
- Moderate AUD: 4-5 criteria
- Severe AUD: 6 or more criteria 3
Comparison with Previous Diagnostic Criteria
The DSM-5 diagnostic criteria for AUD have been compared with those of DSM-IV, DSM-III-R, and ICD-10, with studies showing that the DSM-5 criteria may increase the prevalence rates of AUD 4, 5. The agreement between DSM-5 AUD and dependence or abuse/harm was found to be substantial to almost perfect with DSM-IV, DSM-III-R, and ICD-10 4.