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Alcohol Dependence

Diagnostic Criteria

  1. Alcohol abuse: A destructive pattern of alcohol use, leading to significant social, occupational, or medical impairment.
  2. Must have three (or more) of the following, occurring when the alcohol use was at its worst:
    1. Alcohol tolerance: Either need for markedly increased amounts of alcohol to achieve intoxication, or markedly diminished effect with continued use of the same amount of alcohol.
    2. Alcohol withdrawal symptoms: Either (a) or (b).
    (a) Two (or more) of the following, developing within several hours to a few days of reduction in heavy or prolonged alcohol use:
    • sweating or rapid pulse
    • increased hand tremor
    • insomnia
    • nausea or vomiting
    • physical agitation
    • anxiety
    • transient visual, tactile, or auditory hallucinations or illusions
    • grand mal seizures

    (b) Alcohol is taken to relieve or avoid withdrawal symptoms.

    1. Alcohol was often taken in larger amounts or over a longer period than was intended
    2. Persistent desire or unsuccessful efforts to cut down or control alcohol use
    3. Great deal of time spent in using alcohol, or recovering from hangovers
    4. Important social, occupational, or recreational activities given up or reduced because of alcohol use.
    5. Continued alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been worsened by alcohol (e.g., continued drinking despite knowing that an ulcer was made worse by drinking alcohol)

Associated Feature

  • Learning Problem
  • Dysarthria or Involuntary Movement
  • Depressed Mood
  • Somatic or Sexual Dysfunction
  • Addiction
  • Sexually Deviant Behavior
  • Dramatic or Erratic or Antisocial Personality

Differential Diagnosis

Some disorders display similar or sometimes even the same symptom. The clinician, therefore, in his diagnostic attempt has to differentiate against the following disorders which one needs to be ruled out to establish a precise diagnosis.

  • Nonpathologic alcohol use for recreational or medical purposes;
  • Repeated episodes of Alcohol Intoxication.