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Alcohol and Alcoholism Advance Access published online on July 11, 2005
Alcohol and Alcoholism, 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
Received May 12, 2005
Revised June 20, 2005
Accepted June 21, 2005

Article

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

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, 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 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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