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DSM-IV alcohol dependence and drinking in the U.S. population: A risk analysis

Annals of Epidemiology November 1997, Volume 7, Pages 542–549


PURPOSE:This paper examines the relationship between alcohol dependence according to the criteria found in the 4th edition of the Diagnostic and Statistical Manual (DSM-IV) of the American Psychiatric Association and drinking in the U.S. general population.

METHODS:The data set under analysis is the 1988 National Health Interview Survey, which interviewed a probability sample of 22,102 adult drinkers in the U.S. household population. The response rate was 86%.

RESULTS:Results indicate that there is a linear relationship between DSM-IV dependence and the mean number of drinks consumed per day, or the number of days drinking five or more glasses of alcohol in the past 12 months. Respondents who reported consuming five or more drinks in a day have about six times more chances of being dependent than respondents who did not report such pattern of drinking. Older drinkers are less at risk than younger drinkers.

CONCLUSIONS:There is a risk of alcohol dependence at relatively low volumes of consumption. The risk increases gradually with the volume of consumption. An added and higher risk exists when drinkers engage in a pattern of consumption involving the ingestion of five or more drinks per day.

Keywords: Alcohol Dependence, Drinking, Risk, General Population.


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From the Alcohol Research Group, 2000 Hearst Avenue, Berkeley, CA, USA

Address reprint requests to: Dr. Raul Caetano, Alcohol Research Group, 2000 Hearst Avenue, Berkeley, CA 94709.

Work on this paper was supported by a National Alcohol Research Center Grant (AA-05595) from the National Institute on Alcohol Abuse and Alcoholism to the Alcohol Research Group, Western Consortium for Public Health, 2000 Hearst Avenue, Berkeley, CA 94709.

Editor's Comment:
This paper examines the relationship between alcohol dependence according to the criteria found in DSM-IV, and drinking in the US general population. In the survey conducted, respondents who reported consuming five or more drinks per day were about six times more at risk of being alcohol dependent than those who did not report such drinking patterns. Studying the appearance of dependence indicators at low levels of drinking may help identifying subgroups of drinkers who may be more sensitive to alcohol and thus more at risk for developing dependence, and may help in understanding more about the course of dependence – how it begins and how it changes with time and amount of drinking. Once the alcohol dependence syndrome is installed, chronically dependent individuals may not need high levels of prolonged periods of consumption to present a full-blown syndrome of dependence.


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