title: Craving and withdrawal as core symptoms of alcohol dependence.
abstract: There is ongoing debate regarding the validity of the distinction of alcohol abuse and dependence, the distinction between normality and alcohol abuse, and the absence of craving in the DSM-IV classification of alcohol use disorders. In this study, we examine the discriminant validity of the DSM-IV alcohol use disorder diagnoses in three different populations (98 patients from an alcohol treatment service, 68 nontreatment-seeking heavy drinkers, and 75 psychiatric outpatients). We compare the results of the DSM-IV classification with an alternative classification that requires craving and withdrawal for the diagnosis of dependence and at least two DSM-IV abuse-dependence symptoms for the diagnosis of abuse: the Craving Withdrawal Model (CWM). Although the total prevalence of any alcohol use disorder did not differ between DSM-IV and CWM, the distinction between normality and abuse and between abuse and dependence was better for the CWM categories.
authors.affiliation: St. Lucas Andreas Hospital, Department of Psychiatry, Amsterdam, The Netherlands.
authors.forename: Carla
authors.initials: C
authors.lastname: de Bruijn
authors.forename: Alex
authors.initials: A
authors.lastname: Korzec
authors.forename: Frank
authors.initials: F
authors.lastname: Koerselman
authors.forename: Wim
authors.initials: W
authors.lastname: van Den Brink
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects / Q000523:psychology; D000437:Alcoholism / Q000175:diagnosis* / Q000523:psychology; D000704:Analysis of Variance; D001294:Attitude to Health; D016739:Behavior, Addictive / Q000175:diagnosis* / Q000523:psychology; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D000431:Ethanol / Q000009:adverse effects; D006304:Health Status; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D015203:Reproducibility of Results; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D011795:Surveys and Questionnaires
chemical_list: D000431:Ethanol