The three year course of alcohol use disorders in the general population: DSM‐IV, ICD‐10 and the Craving Withdrawal Model

Bruijn, Carla de; Brink, Wim van den; Graaf, Ron de; Vollebergh, Wilma

doi:10.1111/j.1360-0443.2006.01327.x

Cited by 51 publications

(46 citation statements)

References 43 publications

(46 reference statements)

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“…This suggests that among these medical doctors, the prevalence of alcohol dependence might be lower compared with the general population although hazardous alcohol use patterns might be more prevalent. The fact that such a big difference is found between the percentage of hazardous drinking and the risk level for alcohol dependence might reflect that patterns of hazardous drinking are quite distinct from patterns of alcohol dependence, with both pathologies having a specific natural course in the general population [16]. …”

Section: Discussionmentioning

confidence: 99%

Alcohol Use and Hazardous Drinking among Medical Specialists

2012

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Background: Alcohol use among medical specialists remains a delicate topic. However, the number of prevalence studies remains very limited in Western European countries. Aims: To explore alcohol use and hazardous drinking among male and female medical specialists. Methods: All medical specialists in Belgium – a typical Western European country regarding alcohol use – were invited to participate. Alcohol use and abuse were measured using the Alcohol Use Disorder Identification Test (AUDIT) and the CAGE screen (acronym based on the four items it contains: ‘Cut down drinking’, ‘Annoyed by criticism’, ‘Guilty feelings’ and ‘Eye opener’). Results: A sample of 1,501 specialists completed the survey. The composition of the sample was comparable with that of the overall population of specialists in Belgium regarding gender, age and specialties. A proportion of 18% of the specialists could be classified as hazardous drinkers and 16.8% reported binge drinking at least once a month. Female medical specialists drank less than their male counterparts; however, a substantial proportion of female specialists (14.9%) displayed higher risk levels of hazardous drinking. Significant differences were found between specialties on the CAGE screen. Finally, younger medical specialists tended to display healthier alcohol use patterns compared with their older counterparts. Conclusion: Medical specialists tend to indulge in more hazardous drinking compared with the general population (10%). The alcohol use patterns of female doctors tend to move towards those of males.

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Section: Discussionmentioning

confidence: 99%

Alcohol Use and Hazardous Drinking among Medical Specialists

2012

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“…Indeed, population-based research showed that AUDs, and especially alcohol abuse, are often mild and do not interfere strongly with daily activities [13][14][15] . Moreover, AUDs in the general population are associated with high spontaneous remission rates [16][17][18][19] and thus, not all of those with an AUD diagnosis may need AUDTx. It is undesirable when severe AUD cases do not receive treatment, but when non-treatment (NonTx) users are mild AUD cases with a favorable course, their decision not to seek treatment may be justified and likely be cost effective.…”

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confidence: 99%

Treatment Seeking for Alcohol Use Disorders: Treatment Gap or Adequate Self-Selection?

et al. 2016

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Background/Aims: This study examines whether it is harmful that subjects with an alcohol use disorder (AUD) in the general population rarely seek treatment. Methods: Baseline and 3-year follow-up data from the Netherlands Mental Health Survey and Incidence Study-2 were used. Treatment utilization covered a 4-year period. The Composite International Diagnostic Interview 3.0 assessed AUD and other psychiatric disorders. Results: Of 154 subjects with baseline 12-month DSM-5 AUD, 35.4% used only general treatment (GenTx) for mental problems or alcohol/drugs problems; 10.3% used specialized AUD treatment (AUDTx); and 54.3% used no treatment at all. Of these 3 groups, AUDTx users had the highest severity on AUD characteristics, comorbid psychopathology and mental functioning. Compared to non-treatment (NonTx), GenTx users more often had 12-month emotional disorders at follow-up, but AUD remission rates and functioning were similar. NonTx users functioned similarly at follow-up as people in the general population without lifetime AUD or other psychopathology. Conclusion: Adequate treatment seeking often occurs in the general population: the most severe AUD subjects use AUDTx, and most NonTx users have a mild AUD and a favorable course. Current findings suggest a smaller treatment gap than previously reported, but still one-quarter of the people with AUD do not seek AUDTx but could benefit from this, as they have a persistent AUD.

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“…In this sample, few participants indicated medical problems due to drinking and as such we could not replicate a severe alcohol phenotype in this sample. To this end, however, we did examine symptom count scores on the Craving Withdrawal Model, which has been shown to identify a more severe form of alcohol dependence (de Bruijn et al, 2006). A related limitation is that craving was not self-reported by many adults in this sample.…”

Section: Discussionmentioning

confidence: 99%

“…Clinical levels of abuse in these models are indicated by the presence of two or more of the remaining 10 DSM-IV abuse-dependence symptoms. Each of these models have been validated in general population samples and demonstrate an improved predictive and discriminant validity (de Bruijn et al, 2006;Langenbucher et al, 2000). An important distinction between these two models, however, is the inclusion of craving or the strong desire to consume alcohol in a diagnosis of dependence.…”

Section: Introductionmentioning

confidence: 99%

Between- and Within-Family Association Test of the Dopamine Receptor D2 TaqIA Polymorphism and Alcohol Abuse and Dependence in a General Population Sample of Adults

Haberstick

Timberlake

Smolen

et al. 2007

J. Stud. Alcohol Drugs

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Objective-Dopaminergic dysfunction has been hypothesized to play an important role in the etiology of alcohol use disorders. A restriction fragment length polymorphism (RFLP) in the 3' untranslated region (3'UTR) of the DRD2 gene affects gene expression and has been implicated as a risk factor for alcohol dependence. This polymorphism (TaqIA) has been reported as positively associated with alcohol use disorders in case-control samples, but these results have not been replicated in family-based association studies. These mixed results of association between the DRD2 TaqIA polymorphism and alcohol use disorders may be due to differences in sample size, phenotype definition, heterogeneity of the samples and genetic admixture.Method-We conducted tests of association in a sample of 838 adults participating in the National Youth Survey Family Study (NYSFS). We examined whether the DRD2 TaqIA polymorphism was associated with a symptom counts measure of alcohol abuse and dependence derived from the DSM-IV and Craving Withdrawal models.Results-Tests of association were non-significant across each classification system examined. Power calculations suggested these results were despite the ability to detect an effect size of 1%.Conclusions-This study supports other family-based association tests that have reported no association between the DRD2 TaqIA polymorphism and alcohol abuse and dependence.

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The three year course of alcohol use disorders in the general population: DSM‐IV, ICD‐10 and the Craving Withdrawal Model

Abstract: The conviction that addiction is a chronic relapsing disease may apply to treatment-seeking alcoholics, but our data show a far more favourable course of alcohol use disorders in the general population.

Cited by 51 publications

References 43 publications

Alcohol Use and Hazardous Drinking among Medical Specialists

Alcohol Use and Hazardous Drinking among Medical Specialists

Treatment Seeking for Alcohol Use Disorders: Treatment Gap or Adequate Self-Selection?

Between- and Within-Family Association Test of the Dopamine Receptor D2 TaqIA Polymorphism and Alcohol Abuse and Dependence in a General Population Sample of Adults

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