Implications of co-occurring alcohol abuse for role impairment, health problems, treatment seeking, and early course of alcohol dependence.
This article explores the nosological and clinical implications of co-occurring alcohol abuse and alcohol dependence and examines the hierarchical relationship between these diagnostic categories in the DSM-IV. Among 2,307 alcohol-dependent participants in the 2003 US National Survey on Drug Use and Health, 1,646 (68.1%) additionally met the criteria for alcohol abuse. In multivariate analyses, alcohol-dependent participants with alcohol abuse reported an earlier age of first alcoholic drink compared to those without alcohol abuse. They also reported a higher prevalence of health problems, non-alcohol drug use, impairment, treatment seeking, and early remission. The two groups had different symptom profiles. Revisions to future DSM editions are proposed to better capture these differences.
Department of Psychiatry, Beth Israel Medical Center, New York, New York 10003, USA. rm322@columbia.edu
Ramin
R
Mojtabai
Prameet
P
Singh
D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000517:prevention & control*; D000437:Alcoholism / Q000453:epidemiology* / Q000534:rehabilitation*; D002648:Child; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015995:Prevalence; D012074:Remission Induction; D012380:Role; D012919:Social Behavior