The 5-year clinical course of high-functioning men with DSM-IV alcohol abuse or dependence.
OBJECTIVE
One goal of diagnostic criteria is to predict the course of clinically relevant future problems. This study evaluated the ability of the DSM-IV categories of alcohol abuse and alcohol dependence to predict the onset and cessation of the 11 DSM-IV abuse/dependence criterion items.


METHODS
The DSM-IV categorical approach was used to determine alcohol diagnoses for 435 highly educated young adult men, who constituted 97.3% of the 447 men appropriate for this study. Structured face-to-face follow-up interviews were administered 5 years later.


RESULTS
At the beginning of the study, 14.5% (N=63) of the subjects were alcohol dependent, 18.2% (N=79) reported alcohol abuse, and 67.4% (N=293) carried no alcohol diagnosis. Across these three diagnostic groups, 68.3%, 46.8%, and 15.4%, respectively, experienced at least one of the 11 DSM-IV abuse/dependence criterion items over the next 5 years. Only 11.4% of those who reported alcohol abuse went on to develop alcohol dependence. In addition to their diagnosis, characteristics that predicted subsequent problems with alcohol included a family history of alcoholism, higher levels of alcohol intake and a greater number of alcohol problems in the 10 years preceding the diagnosis, and a history of drug use.


CONCLUSIONS
Even in this highly educated and high-functioning group of men, alcohol abuse and dependence predicted the onset and cessation of alcohol-related problems.
Schuckit
M A
MA
Department of Psychiatry, VA Medical Center, VA San Diego Healthcare System, California 92121-2002, USA. mshuckit@ucsd.edu
Smith
T L
TL
Landi
N A
NA
D000328:Adult; D000428:Alcohol Drinking; D019973:Alcohol-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D000437:Alcoholism / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D004522:Educational Status; D005500:Follow-Up Studies; D006801:Humans; D007182:Income; D016015:Logistic Models; D008297:Male; D017533:Marital Status; D011336:Probability; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012044:Regression Analysis; D012307:Risk Factors; D012737:Sex Factors; D012923:Social Class; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology; D009626:Terminology as Topic