This study examined the diagnostic criteria for alcohol use disorder (AUD), emphasizing the need for a more nuanced approach beyond simple criterion counts. Current diagnostic systems, such as the DSM-5, rely on counting the number of criteria met, without considering the heterogeneity among criteria. By analyzing data from a large cohort, the study highlights the importance of specific “high-risk” criteria, such as withdrawal symptoms, in identifying greater AUD severity. Even among those with mild-to-moderate AUD, individuals endorsing these high-risk criteria displayed heavier drinking patterns and increased psychiatric comorbidity. Importantly, those with mild-to-moderate AUD and high-risk criteria were twice as likely to progress to severe AUD, suggesting the significance of these specific criteria in predicting disorder progression. This research underscores the benefits of putting emphasis on particularly severe criteria into AUD diagnostics to better identify individuals at a higher risk of developing severe forms of the disorder.
Miller AP, Kuo SIC, Johnson EC, Tillman R, Brislin SJ, Dick DM, Kamarajan C, Kinreich S, Kramer J, McCutcheon VV, Plawecki MH, Porjesz B, Schuckit MA, Salvatore JE, Edenberg HJ, Bucholz KK, Meyers JL, Agrawal A (2023) Specific diagnostic criteria identify those at high risk for progression from ‘preaddiction’ to severe alcohol use disorder. medRxiv, 2023.2006.2012.23291164. DOI: 10.1101/2023.06.12.23291164.