A commentary on the proposed changes in DSM-III concept of alcohol dependence

This paper discusses changes in the DSM-III diagnosis of alcohol dependence as proposed by Rounsaville, Spitzer and Williams (Am. J. Psychiatry 143 (1986) 463). The discussion covers the following issues: the changes in the concept of alcohol abuse and the expansion of the concept of alcohol dependence, the withdrawal of indicators of social and occupational impairment, the phraseology used in the new indicators, the lack of a time frame to evaluate the indicators as present, and the relationship of the new diagnosis with compulsive behaviors and with the Alcohol Dependence Syndrome of the International Classification of Diseases-9th Revision.