title: Diagnostic orphans for alcohol use disorders in a treatment-seeking psychiatric sample.
abstract: Individuals who endorse one or two of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criterion items for alcohol dependence but do not meet criteria for either alcohol abuse or dependence have been referred to in the literature as "diagnostic orphans." The goal of the present study is to compare diagnostic orphans for alcohol use disorders (AUD) to patients with lifetime DSM-IV alcohol abuse, alcohol dependence, and those with no-AUD symptoms on a series of demographic, diagnostic, and clinical measures. Participants were treatment-seeking psychiatric outpatients (n=1793; 61.5% women) who completed an in-depth, face-to-face diagnostic evaluation for DSM-IV axis I and axis II disorders. Results revealed that diagnostic orphans were younger, had a higher frequency of family history positive for alcoholism, and higher rates of cannabis dependence, as compared to the no-AUD symptoms group. Diagnostic orphans differed significantly from patients with alcohol abuse and dependence on a number of demographic, diagnostic, and clinical measures. Most notably, on a lifetime basis, diagnostic orphans were less likely to meet diagnostic criteria for various substance use disorders, as compared to individuals with alcohol abuse and dependence. Taken together, these results generally do not support combining diagnostic orphans to individuals with alcohol abuse.
authors.affiliation: Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA. Lara_Ray@brown.edu <Lara_Ray@brown.edu>
authors.forename: Lara A
authors.initials: LA
authors.lastname: Ray
authors.forename: Robert
authors.initials: R
authors.lastname: Miranda
authors.forename: Iwona
authors.initials: I
authors.lastname: Chelminski
authors.forename: Diane
authors.initials: D
authors.lastname: Young
authors.forename: Mark
authors.initials: M
authors.lastname: Zimmerman
mesh_terms: D000328:Adult; D000367:Age Factors; D019973:Alcohol-Related Disorders / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology; D000437:Alcoholism / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology; D000553:Ambulatory Care; D016009:Chi-Square Distribution; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005190:Family; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D002189:Marijuana Abuse / Q000175:diagnosis / Q000453:epidemiology; D001523:Mental Disorders / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology; D010342:Patient Acceptance of Health Care; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D011594:Psychometrics