Differentiating DSM-IV alcohol dependence and abuse by course: community heavy drinkers

The purpose of this study was to investigate the differences in short-term course between DSM-IV alcohol abuse and alcohol dependence in a community sample of men and women. Eight hundred seventy-six individuals were given a baseline interview that included DSM-IV criteria for alcohol use disorders, and were followed up with a similar interview approximately one year later. Group differences were compared with chi-square tests. Multinomial logistic regression analyses were used to test group differences controlling for potential confounders. The course of alcohol abuse and dependence differed significantly from each other, and from individuals with no alcohol diagnosis at baseline. Chronicity was the most common outcome for dependence but not for abuse. Most subjects with baseline diagnoses of abuse received the diagnosis with only one symptom, repeated drunk driving. While the validity of the alcohol dependence diagnosis was supported in this community sample, the results concerning alcohol abuse remain equivocal.