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Subthreshold problem drinkers in DSM-5 alcohol use disorder classification.

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Subthreshold problem drinkers represent a significant group with risky drinking patterns. However, they do not consistently progress to alcohol use disorder (AUD) and may not be a distinct subgroup under the current DSM-5 classification.

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Area of Science:

  • Psychiatry
  • Addiction Medicine
  • Public Health

Background:

  • The DSM-5 introduced criteria for alcohol use disorder (AUD) to identify subthreshold cases.
  • Few studies have investigated the characteristics of these subthreshold problem drinkers.

Purpose of the Study:

  • To determine if subthreshold problem drinkers constitute a distinct subgroup within the DSM-5 AUD classification.
  • To investigate their drinking patterns and longitudinal trajectories.

Main Methods:

  • Utilized data from the Cohort Study on Substance Use Risk Factors involving young Swiss men (n=4,630).
  • Assessed participants at two time points using the 11 DSM-5 AUD criteria and drinking pattern variables.

Main Results:

  • Approximately 23% of drinkers were classified as subthreshold problem drinkers at baseline and follow-up.
  • A significant portion (29.4%) remained in this category over time.
  • Subthreshold drinkers exhibited drinking patterns intermediate to symptom-free and AUD groups.

Conclusions:

  • Subthreshold problem drinkers are a notable group with risky drinking, but not necessarily a consistent precursor to AUD.
  • AUD appears to be a dimensional construct, with more criteria correlating with adverse outcomes.