title: DSM-5 criteria for substance use disorders: recommendations and rationale.
abstract: Since DSM-IV was published in 1994, its approach to substance use disorders has come under scrutiny. Strengths were identified (notably, reliability and validity of dependence), but concerns have also arisen. The DSM-5 Substance-Related Disorders Work Group considered these issues and recommended revisions for DSM-5. General concerns included whether to retain the division into two main disorders (dependence and abuse), whether substance use disorder criteria should be added or removed, and whether an appropriate substance use disorder severity indicator could be identified. Specific issues included possible addition of withdrawal syndromes for several substances, alignment of nicotine criteria with those for other substances, addition of biomarkers, and inclusion of nonsubstance, behavioral addictions.This article presents the major issues and evidence considered by the work group, which included literature reviews and extensive new data analyses. The work group recommendations for DSM-5 revisions included combining abuse and dependence criteria into a single substance use disorder based on consistent findings from over 200,000 study participants, dropping legal problems and adding craving as criteria, adding cannabis and caffeine withdrawal syndromes, aligning tobacco use disorder criteria with other substance use disorders, and moving gambling disorders to the chapter formerly reserved for substance-related disorders. The proposed changes overcome many problems, while further studies will be needed to address issues for which less data were available.
authors.affiliation: New York State Psychiatric Institute, New York, USA. dsh2@columbia.edu
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Hasin
authors.forename: Charles P
authors.initials: CP
authors.lastname: O'Brien
authors.forename: Marc
authors.initials: M
authors.lastname: Auriacombe
authors.forename: Guilherme
authors.initials: G
authors.lastname: Borges
authors.forename: Kathleen
authors.initials: K
authors.lastname: Bucholz
authors.forename: Alan
authors.initials: A
authors.lastname: Budney
authors.forename: Wilson M
authors.initials: WM
authors.lastname: Compton
authors.forename: Thomas
authors.initials: T
authors.lastname: Crowley
authors.forename: Walter
authors.initials: W
authors.lastname: Ling
authors.forename: Nancy M
authors.initials: NM
authors.lastname: Petry
authors.forename: Marc
authors.initials: M
authors.lastname: Schuckit
authors.forename: Bridget F
authors.initials: BF
authors.lastname: Grant
mesh_terms: D039721:Diagnostic and Statistical Manual of Mental Disorders; D019317:Evidence-Based Medicine; D006801:Humans; D013375:Substance Withdrawal Syndrome / Q000145:classification / Q000175:diagnosis / Q000523:psychology; D019966:Substance-Related Disorders / Q000145:classification* / Q000175:diagnosis* / Q000523:psychology; D014481:United States
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