title: A Cross-National Examination of Differences in Classification of Lifetime Alcohol Use Disorder Between DSM-IV and DSM-5: Findings from the World Mental Health Survey.
abstract: The current study sought to examine the diagnostic overlap in DSM-IV and DSM-5 alcohol use disorder (AUD) and determine the clinical correlates of changing diagnostic status across the 2 classification systems.
  
  
  
  DSM-IV and DSM-5 definitions of AUD were compared using cross-national community survey data in 9 low-, middle-, and high-income countries. Participants were 31,367 respondents to surveys in the World Health Organization's World Mental Health Survey Initiative. The Composite International Diagnostic Interview, version 3.0, was used to derive DSM-IV and DSM-5 lifetime diagnoses of AUD. Clinical characteristics, also assessed in the surveys, included lifetime DSM-IV anxiety; mood and drug use disorders; lifetime suicidal ideation, plan, and attempt; general functional impairment; and psychological distress.
  
  
  
  Compared with DSM-IV AUD (12.3%, SE = 0.3%), the DSM-5 definition yielded slightly lower prevalence estimates (10.8%, SE = 0.2%). Almost one-third (n = 802) of all DSM-IV abuse cases switched to subthreshold according to DSM-5 and one-quarter (n = 467) of all DSM-IV diagnostic orphans switched to mild AUD according to DSM-5. New cases of DSM-5 AUD were largely similar to those who maintained their AUD across both classifications. Similarly, new DSM-5 noncases were similar to those who were subthreshold across both classifications. The exception to this was with regard to the prevalence of any lifetime drug use disorder.
  
  
  
  In this large cross-national community sample, the prevalence of DSM-5 lifetime AUD was only slightly lower than the prevalence of DSM-IV lifetime AUD. Nonetheless, there was considerable diagnostic switching, with a large number of people inconsistently identified across the 2 DSM classifications.
authors.affiliation: National Drug and Alcohol Research Centre, UNSW Australia, Sydney, New South Wales, Australia.
authors.forename: Tim
authors.initials: T
authors.lastname: Slade
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.
authors.forename: Wai-Tat
authors.initials: WT
authors.lastname: Chiu
authors.affiliation: Department of Epidemiology, Services, and Prevention Research (DESPR), National Institute on Drug Abuse (NIDA), National Institutes of Health (NIH), Bethesda, Maryland.
authors.forename: Meyer
authors.initials: M
authors.lastname: Glantz
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
authors.affiliation: National Drug and Alcohol Research Centre, UNSW Australia, Sydney, New South Wales, Australia.
authors.forename: Luise
authors.initials: L
authors.lastname: Lago
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.
authors.forename: Nancy
authors.initials: N
authors.lastname: Sampson
authors.affiliation: College of Medicine, Al-Qadisiya University, Diwania governorate, Iraq.
authors.forename: Ali
authors.initials: A
authors.lastname: Al-Hamzawi
authors.affiliation: National School of Public Health, Management and Professional Development, Bucharest, Romania.
authors.forename: Silvia
authors.initials: S
authors.lastname: Florescu
authors.affiliation: Department of Studies on Alcoholism and Drug Dependence, Institute of Psychiatry and Neurology, Warsaw, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Moskalewicz
authors.affiliation: School of Psychology, University of Ulster, Belfast, Ireland.
authors.forename: Sam
authors.initials: S
authors.lastname: Murphy
authors.affiliation: IMIB-Arrixaca, CIBERESP-Murcia, Subdirección General de Salud Mental y Asistencia Psiquiátrica, Servicio Murciano de Salud, El Palmar, Murcia, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Navarro-Mateu
authors.affiliation: Center for Excellence on Research in Mental Health, CES University, Medellin, Colombia.
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Torres de Galvis
authors.affiliation: Department of Social Medicine, Federal University of Espírito Santo, Vitoria, Brazil.
authors.forename: Maria Carmen
authors.initials: MC
authors.lastname: Viana
authors.affiliation: Nova Medical School/Faculdade Ciencias Medicas-Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal.
authors.forename: Miguel
authors.initials: M
authors.lastname: Xavier
authors.affiliation: National Drug and Alcohol Research Centre, UNSW Australia, Sydney, New South Wales, Australia.
authors.forename: Louisa
authors.initials: L
authors.lastname: Degenhardt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019973:Alcohol-Related Disorders / Q000145:classification* / Q000175:diagnosis* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D014943:Global Health / Q000145:classification*; D006306:Health Surveys / Q000145:classification* / Q000592:standards; D006801:Humans; D038622:Internationality; D008297:Male; D008603:Mental Health / Q000145:classification*; D008875:Middle Aged; D014944:World Health Organization; D055815:Young Adult
keywords: Alcohol Use Disorder; DSM-5; DSM-IV; Prevalence