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16-September-2008 16:15:17 - dependence Alcohol Dependence Classification and external resources ICD-10 F10..2 ICD-9 303 Alcohol dependence, as described in the DSM-IV, is a psychiatric diagnosis describing a physical dependence on alcohol. For a person to meet criteria for Alcohol Dependence 303.90 within the criteria listed in the DSM-IV, they must meet 3 of a total 7 possible criteria within a 12 month period. The first 2 criteria are related to physiological dependence: tolerance and withdrawal. The 3rd and 4th criteria establish a pattern of losing control of drinking by breaking drinking rules or failing at attempts to quit or cut back. The 5th and 6th criteria are indicative of a progression of addiction as more and more time is spent on drinking and lifestyle changes result. The seventh criteria for Alcohol Dependence is met when a person continues to drink despite being aware that their drinking is causing or excacerbating some psychological or physiological problems. It is important to note that because only 3 criteria of 7 are required in order to be diagnosed with Alcohol Dependence, not all meet the same criteria and therefore not all have the same symptoms and problems related to drinking. Not everyone with Alcohol Dependence, therefore, experiences physiological dependence. Alcohol Dependence is differentiated from alcohol abuse by the presence of symptoms such as tolerance and withdrawal. Both alcohol dependence and alcohol abuse are sometimes referred to by the less specific term alcoholism. However, many definitions of alcoholism exist, and only some are compatible with alcohol abuse. About 12% of American adults have had an alcohol dependence problem at some time in their life.1 Alcohol dependence is acknowledged by the American Medical Association as a disease because it has a characteristic set of signs and symptoms and a progressive course. The contemporary definition of alcohol dependence is still based upon early research. There has been considerable scientific effort over the past three decades to identify and understand the core features of alcohol dependence. This work began in 1976 when the British psychiatrist Griffith Edwards and his American colleague Milton M. Gross 2 collaborated to produce a formulation of what had previously been understood as 'alcoholism' - the alcohol dependence syndrome. The alcohol dependence syndrome was seen as a cluster of seven elements that concur. It was argued that not all elements may be present in every case, but the picture is sufficiently regular and coherent to permit clinical recognition. The syndrome was also considered to exist in degrees of severity rather than as a categorical absolute. Thus, the proper question is not 'whether a person is dependent on alcohol', but 'how far along the path of dependence has a person progressed'. The following elements are the template for which the degree of dependence is judged: Narrowing of the drinking repertoire. Increased salience of the need for alcohol over competing needs and responsibilities. An acquired tolerance to alcohol. Withdrawal symptoms. Relief or avoidance of withdrawal symptoms by further drinking. Subjective awareness of compulsion to drink. Reinstatement after abstinence. 3 This medical article is a stub. Notes ^ Hasin D et al 2007. Prevalence, Correlates, Disability, and Comorbidity of DSM-IV Alcohol Abuse and Dependence in the United States. Archives of General Psychiatry 64 7: 830. doi:10.1001/archpsyc.64.7.830. PMID 17606817. ^ Edwards G. Gross MM, Alcohol dependence: provisional description of a clinical syndrome, BMJ 1976; i: 1O58-106 ^ Clark, David, Background Briefing, Alcohol Dependence, Drink and Drug News, 7 February, 2005, p. 11 v d e WHO ICD-10 mental and behavioral disorders F · 290-319 Neurological/symptomatic Dementia Alzheimer's disease, multi-infarct dementia, Pick's disease, Creutzfeldt-Jakob disease, Huntington's disease, Parkinson's disease, AIDS dementia complex, Frontotemporal dementia · Delirium · Post-concussion syndrome · Organic brain syndrome Psychoactive substance alcohol drunkenness, alcohol dependence, alcoholic hallucinosis, Alcohol withdrawal, delirium tremens, Korsakoff's syndrome, alcohol abuse · opioids opioid dependency · sedative/hypnotic benzodiazepine withdrawal · cocaine cocaine dependence · general Intoxication, Drug abuse, Physical dependence, Withdrawal Psychotic disorder Schizophrenia disorganized schizophrenia · Schizophreniform disorder · Schizotypal personality disorder · Delusional disorder · Folie à deux · Schizoaffective disorder Mood affective Mania · Bipolar disorder · Clinical depression · Cyclothymia · Dysthymia Neurotic, stress-related and somatoform Anxiety disorder Agoraphobia, Panic disorder, Panic attack, Generalized anxiety disorder, Social anxiety, Social phobia · OCD · Acute stress reaction · PTSD · Adjustment disorder · Conversion disorder Ganser syndrome · Somatoform disorder Somatization disorder, Body dysmorphic disorder, Hypochondriasis, Nosophobia, Da Costa's syndrome, Psychalgia · Neurasthenia Physiological/physical behavioral Eating disorder: Anorexia nervosa · Bulimia nervosa Sleep disorder: Dyssomnia Hypersomnia, Insomnia · Parasomnia REM behavior disorder, Night terror · Nightmare Sexual dysfunction: Erectile dysfunction · Premature ejaculation · Vaginismus · Dyspareunia · Hypersexuality · Female sexual arousal disorder Postpartum depression · Postnatal psychosis Adult personality and behavior Personality disorder · Passive-aggressive behavior · Kleptomania · Trichotillomania · Voyeurism · Factitious disorder · Munchausen syndrome · Ego-dystonic sexual orientation · Fetishism Mental retardation Mental retardation Psychological development developmental disorder Specific: speech and language expressive language disorder, aphasia, expressive aphasia, receptive aphasia, Landau-Kleffner syndrome, lisp · Scholastic skills dyslexia, dysgraphia, Gerstmann syndrome · Motor function developmental dyspraxia Pervasive: Autism · Rett syndrome · Asperger syndrome Behavioral and emotional, childhood and adolescence onset ADHD · Conduct disorder · Oppositional defiant disorder · Separation anxiety disorder · Selective mutism · Reactive attachment disorder · Tic disorder · Tourette syndrome · Speech stuttering · cluttering Retrieved from http://en..org/wiki/Alcohol_dependence Categories: Medicine stubs | Drinking culture | Substance-related disorders Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page This page was last modified on 21 June 2008, at 16:0
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