title: From DSM-IV to DSM-5 alcohol use disorder: an overview of epidemiological data.
abstract: BACKGROUND
  The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has made several changes to criteria for alcohol use disorder (AUD). The objective of this systematic review is to assess if new DSM-5 diagnostic criteria will increase the prevalence rates of AUD in clinical and non-clinical samples as compared with DSM-IV criteria.
  
  
  METHODS
  We searched PubMed, Scopus, and PsycINFO (via ProQuest) electronic databases, with no language restrictions. We included studies with data available on both DSM-IV (and DSM-IV-TR) and DSM-5 AUD in samples of adults, estimating from each study an expected increase in prevalence rates with relevant 95% confidence intervals (CIs).
  
  
  RESULTS
  Twelve studies were included in this review. Seven studies showed an increase, two no substantial difference, and three a decrease in AUD prevalence according to DSM-5 diagnostic criteria, with differences in rates (95% CIs) varying between -12.4% (-27.4 to +5.6%) and +61.3% (+46.7 to +77.3%). Additional analyses provided confirmatory results.
  
  
  CONCLUSIONS
  DSM-5 diagnostic criteria seem to inflate prevalence rates of AUD as compared with DSM-IV. The increasing likelihood of a DSM-5 AUD diagnosis may be explained by the amount of DSM-IV 'diagnostic orphans' which are more prevalent than DSM-IV single-criterion alcohol abuse individuals. Further research should be aimed to study if similar trends are detectable also for other substance use disorders that experienced similar changes in DSM-5 diagnostic criteria.
authors.affiliation: Department of Surgery and Translational Medicine, University of Milano Bicocca, Via Cadore 48, 20900 Monza, MB, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Bartoli
authors.affiliation: Division of Psychiatry, Faculty of Brain Sciences, University College London, Charles Bell House, 67-73 Riding House Street, London W1W7EJ, UK. Electronic address: g.carra@ucl.ac.uk.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Carrà
authors.affiliation: Department of Surgery and Translational Medicine, University of Milano Bicocca, Via Cadore 48, 20900 Monza, MB, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Crocamo
authors.affiliation: Department of Surgery and Translational Medicine, University of Milano Bicocca, Via Cadore 48, 20900 Monza, MB, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Clerici
mesh_terms: D019973:Alcohol-Related Disorders / Q000453:epidemiology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D015995:Prevalence
keywords: Alcohol use disorder; DSM-5; DSM-IV; Prevalence