Alcoholism: development of the diagnostic concept

This paper traces the diagnostic concepts of alcoholism featured in the major classification systems over the past 40 years. The description of alcoholism as a diagnostic concept has undergone considerable transformation over this time, but an international consensus now exists in the DSM-IIIR [2] criteria and ICD-10 [3]. Alcoholism is equated with alcohol dependence, and both definitions draw largely on the description of the alcohol dependence syndrome by Edwards and Gross [4]. Although the presence of withdrawal symptoms and relief use (key aspects of so-called physical addiction) is part of both systems, they are not necessary to make the diagnosis in either. Future directions and clinical implications of these developments are discussed.