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The craving withdrawal model for alcoholism: towards the DSM-V. Improving the discriminant validity of alcohol use disorder diagnosis.
Alcohol Alcohol. 2005 Jul-Aug; 40(4):314-22.AA

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.

Authors+Show Affiliations

Department of Psychiatry, University Medical Centre Utrecht, Utrecht, The Netherlands. h.debruijn-2@psych.azu.nlNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

15883129

Citation

de Bruijn, Carla, et al. "The Craving Withdrawal Model for Alcoholism: Towards the DSM-V. Improving the Discriminant Validity of Alcohol Use Disorder Diagnosis." Alcohol and Alcoholism (Oxford, Oxfordshire), vol. 40, no. 4, 2005, pp. 314-22.
de Bruijn C, van den Brink W, de Graaf R, et al. The craving withdrawal model for alcoholism: towards the DSM-V. Improving the discriminant validity of alcohol use disorder diagnosis. Alcohol Alcohol. 2005;40(4):314-22.
de Bruijn, C., van den Brink, W., de Graaf, R., & Vollebergh, W. A. (2005). The craving withdrawal model for alcoholism: towards the DSM-V. Improving the discriminant validity of alcohol use disorder diagnosis. Alcohol and Alcoholism (Oxford, Oxfordshire), 40(4), 314-22.
de Bruijn C, et al. The Craving Withdrawal Model for Alcoholism: Towards the DSM-V. Improving the Discriminant Validity of Alcohol Use Disorder Diagnosis. Alcohol Alcohol. 2005 Jul-Aug;40(4):314-22. PubMed PMID: 15883129.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The craving withdrawal model for alcoholism: towards the DSM-V. Improving the discriminant validity of alcohol use disorder diagnosis. AU - de Bruijn,Carla, AU - van den Brink,Wim, AU - de Graaf,Ron, AU - Vollebergh,Wilma A M, Y1 - 2005/05/09/ PY - 2005/5/11/pubmed PY - 2005/9/24/medline PY - 2005/5/11/entrez SP - 314 EP - 22 JF - Alcohol and alcoholism (Oxford, Oxfordshire) JO - Alcohol Alcohol VL - 40 IS - 4 N2 - 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. SN - 0735-0414 UR - https://www.unboundmedicine.com/medline/citation/15883129/The_craving_withdrawal_model_for_alcoholism:_towards_the_DSM_V__Improving_the_discriminant_validity_of_alcohol_use_disorder_diagnosis_ DB - PRIME DP - Unbound Medicine ER -