Skip Navigation



Alcohol and Alcoholism Advance Access published online on May 9, 2005
Alcohol and Alcoholism, doi:10.1093/alcalc/agh166
This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
40/4/314    most recent
agh166v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by DE BRUIJN, C.
Right arrow Articles by A. M. VOLLEBERGH, W.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by DE BRUIJN, C.
Right arrow Articles by A. M. VOLLEBERGH, W.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author 2005. Published by Oxford University Press on behalf of the Medical Council on Alcohol. All rights reserved
Received October 12, 2004
Revised April 3, 2005
Accepted April 14, 2005

Article

THE CRAVING WITHDRAWAL MODEL FOR ALCOHOLISM: TOWARDS THE DSM-V. IMPROVING THE DISCRIMINANT VALIDITY OF ALCOHOL USE DISORDER DIAGNOSIS

CARLA DE BRUIJN 1*, WIM VAN DEN BRINK 2, RON DE GRAAF 3, and WILMA A. M. VOLLEBERGH 3

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

* To whom correspondence should be addressed.
CARLA DE BRUIJN, E-mail: h.debruijn-2{at}psych.azu.nl


  Abstract

Aims: To compare the discriminant validity of the DSM-IV and the ICD-10 classification of alcohol use disorders (AUD) with an alternative classification, the craving withdrawal model (CWM). CWM requires craving and withdrawal for the diagnosis of alcohol dependence and raises the alcohol abuse threshold to two DSM-IV AUD criteria. Methods: Data were derived from The Netherlands Mental Health Survey and Incidence Study, a large representative sample of the general Dutch population. In the present study, only non-abstinent subjects were included (n = 6041). Three diagnostic systems (DSM-IV, ICD-10, and CWM) were compared using the following discriminant variables: alcohol intake, psychiatric comorbidity, functional status, familial alcohol problems, and treatment sought. Results: The year prevalence of CWM alcohol dependence was lower than the prevalence of ICD-10 and DSM-IV dependence (0.3% vs 1.4% and 1.4%). The year prevalence of abuse was similar for CWM and DSM-IV (4.7 and 4.9%), but lower for ICD-10 harmful use (1.7%). DSM-IV resulted in a poor distinction between normality and abuse and ICD-10 resulted in a poor distinction between harmful use and dependence. In contrast, the CWM distinctions between normality and abuse, and between abuse, and dependence were significant for most of the discriminant variables. Conclusion: This study indicates that CWM improves the discriminant validity of AUD diagnoses. The predictive validity of the CWM for alcohol and other substance use disorders remain to be studied.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Am. J. PsychiatryHome page
C. de BRUIJN and W. van den BRINK
Validity of the One-Criterion Threshold for an Alcohol Abuse Diagnosis
Am J Psychiatry, December 1, 2005; 162(12): 2400 - 2400.
[Full Text] [PDF]

Home page
 Alcohol AlcoholHome page
C. DE BRUIJN, W. VAN DEN BRINK, R. DE GRAAF, and W. A. M. VOLLEBERGH
ALCOHOL ABUSE AND DEPENDENCE CRITERIA AS PREDICTORS OF A CHRONIC COURSE OF ALCOHOL USE DISORDERS IN THE GENERAL POPULATION
Alcohol Alcohol., September 1, 2005; 40(5): 441 - 446.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.