Using cluster analysis of alcohol use disorders to investigate 'diagnosticorphans': subjects with alcohol dependence symptoms but no diagnosis

The purpose of this paper is to examine the characteristics of community su bjects with one or two alcohol dependence symptoms who did not satisfy the criteria for Diagnostic and Statistical Manual of Mental Disorders-Fourth E dition (DSM-IV) alcohol dependence or abuse (sub-diagnostic group or diagno stic orphans). Variables not included in the DSM-IV alcohol abuse and depen dence criteria are used to compare the different alcohol statuses. The resu lts indicate that the sub-diagnostic group 'diagnostic orphans' formed a cl uster distinct from that of the non-problem drinkers group, and appeared to be closer to those with alcohol abuse than to those with alcohol dependenc e. The diagnosis of DSM-IV alcohol dependence (with three, four, or five or more symptoms) appeared to be its own entity. The findings lend credence t o the requirement of three symptoms (in any 12 months) for the diagnosis of alcohol dependence in DSM-IV. However, those with one or two symptoms of a lcohol dependence should be considered along with alcohol abuse as an entit y in future DSM classifications. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.