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Box 13-3

DSM-IV Criteria for Diagnosis of Alcohol-Related Syndrome

Alcohol abuse—Maladaptive pattern of alcohol use that is manifested by one or more of the following within the same 12 months:

  1. Inability to fulfill major role obligations at work, school, and home
  2. Recurrent legal or interpersonal problems
  3. Reduction or absence of important social, occupational, and recreational activities
  4. Participation in physically hazardous situations while impaired, for example, driving a car, exacerbation of a symptom

Alcohol dependence—Maladaptive pattern of alcohol use leading to impairment by three or more of the following occurring at any time during the same 12 months:

  1. All criteria for alcohol abuse
  2. Presence of tolerance to drug
  3. Presence of alcohol withdrawal syndrome
  4. Ingestion of alcohol to relieve or prevent withdrawal
  5. Taking more alcohol over longer period of time than intended
  6. Unsuccessful or persistent desire to cut down or control use
  7. Great deal of time spent in getting, taking, and recovering from alcohol

Alcohol withdrawal—Cessation of alcohol use which has been heavy and prolonged and has at least 2 of the following within several hours to a few days:

  1. Autonomic hyperactivity (high blood pressure, tachycardia, fever)
  2. Hand tremor
  3. Insomnia
  4. Nausea and/or vomiting
  5. Anxiety
  6. Transient visual, tactile, or auditory hallucinations or illusions
  7. Grand mal seizures

Alcohol-induced delirium—An organic mental disorder with symptoms in excess of the usual withdrawal (formerly called “delirium tremens”) or intoxication symptoms that occurs after cessation or reduction of long-term heavy drinking or during intoxication. In someone with a history of substance use, symptoms include

  1. Impaired consciousness
  2. Changes in cognition including memory, language, disorientation, hallucinations (especially tactile such as feeling bugs crawling on one’s body)
  3. Develops over short period of time (hours to days) and fluctuates over a day.

Source: American Psychiatric Association (APA). (2000). Diagnostic and statistical manual of mental disorders—text revision (TR.) Washington, DC: American Psychiatric Association.