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Alcohol and Alcoholism Advance Access originally published online on July 11, 2005
Alcohol and Alcoholism 2005 40(5):441-446; doi:10.1093/alcalc/agh183
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© The Author 2005. Published by Oxford University Press on behalf of the Medical Council on Alcohol. All rights reserved

ALCOHOL ABUSE AND DEPENDENCE CRITERIA AS PREDICTORS OF A CHRONIC COURSE OF ALCOHOL USE DISORDERS IN THE GENERAL POPULATION

CARLA DE BRUIJN*, WIM VAN DEN BRINK1,2, RON DE GRAAF3 and WILMA A. M. VOLLEBERGH3

Department of Psychiatry, University Medical Centre, Utrecht, The Netherlands, 1 Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands, 2 Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands and 3 Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands

* Author to whom correspondence should be addressed at: University Medical Centre, Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands. Tel: +31 30 2507467; Fax: +31 30 2505443; E-mail: h.debruijn-2{at}psych.azu.nl

(Received 12 May 2005; first review notified 1 June 2005; in revised form 20 June 2005; accepted 21 June 2005)

Aims: To investigate whether DSM-IV abuse and dependence criteria and the ICD-10 criterion for craving differentially predict a chronic course of alcohol use disorders (AUD) in the general population. Methods: Data were derived from the Netherlands Mental Health Survey and Incidence Study, a large representative sample of the general Dutch population with a baseline and a 1- and 3-year follow-up assessment. In the present study, a cohort of subjects with a DSM-IV AUD diagnosis at baseline was followed (n = 382). Diagnostic criteria of AUD according to DSM-IV and ICD-10 were assessed using the Composite International Diagnostic Interview (CIDI). Results: In our cohort of subjects with an AUD diagnosis at baseline, the presence of all dependence criteria, except tolerance, significantly increased the risk for dependence at 1 and 3 years follow-up. Abuse criteria displayed much lower and often non-significant risks for dependence at follow-up, with the exception of the criterion ‘legal problems’. The ICD-10 criterion ‘craving’ had the highest relative risk (RR) of all criteria for dependence at 1 year (RR = 12.4, 95% CI = 5.5–27.8) and 3 years follow-up (RR = 12.9, 95% CI = 4.4–37.7). Conclusion: With the exception of tolerance, all DSM-IV dependence criteria are useful in predicting the course of AUD in the general population.


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