Symptoms and characteristics of individuals with different types of recovery from DSM-IV alcohol dependence.
Symptoms and criteria for DSM-IV alcohol dependence and demographic and drinking characteristics are compared for three groups. Group I (N = 1,044) consists of persons who formerly met the criteria for dependence but were abstinent in the past year, Group II (N = 2,325) consists of persons who were formerly dependent but did not meet the criteria for abuse or dependence in the past year despite drinking, and Group III (N = 22,204) consists of persons who never met the criteria for dependence. Members of Group II lay between members of Groups I and III in terms of the numbers of prior dependence symptoms and criteria, past level of intake, degree of familial alcoholism and history of alcohol treatment. Both groups of former alcoholics were equally likely to have experienced withdrawal, drinking more/longer than intended and tolerance. The criteria that most strongly distinguished the groups were continued use despite physical or psychological consequences, time spent drinking and activities given up, all of which were far more common in Group I than in Group II. Members of Group II had earlier onsets of heavy drinking and dependence than members of Group I, supporting the existence of a developmentally limited subtype of alcoholism that is subject to spontaneous remission in early adulthood without treatment. The paper compares three options for tightening the criteria for dependence, all of which remove more members from Group II (28% to 41% depending on option) than from Group I (12% to 19%).
Dawson
D A
DA
Division of Biometry and Epidemiology, National Institutes on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892-7003, USA.
D000328:Adult; D000430:Alcohol Withdrawal Delirium / Q000175:diagnosis; D000437:Alcoholism / Q000145:classification / Q000175:diagnosis / Q000235:genetics / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007206:Individuality; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome