The 5-year clinical course of high-functioning men with DSM-IV alcohol abuse or dependence

Objective: One goal of diagnostic criteria is to predict the course of clin ically relevant future problems. This study evaluated the ability of the DS M-IV categories of alcohol abuse and alcohol dependence to predict the onse t and cessation of the 11 DSM-IV abuse/dependence criterion items. Method: The DSM-IV categorical approach was used to determine alcohol diagn oses for 435 highly educated young adult men, who constituted 97.3% of the 447 men appropriate for this study. Structured face-to-face follow-up inter views were administered 5 years later. Results: At the beginning of the study, 14.5% (N=63) of the subjects were a lcohol dependent, 18.2% (N=79) reported alcohol abuse, and 67.4% (N=293) ca rried no alcohol diagnosis. Across these three diagnostic groups, 68.3%, 46 .8%, and 15.4%, respectively, experienced at least one of the 11 DSM-IV abu se/dependence criterion items over the next 5 years. Only 11.4% of those wh o reported alcohol abuse went on to develop alcohol dependence. In addition to their diagnosis, characteristics that predicted subsequent problems wit h alcohol included a family history of alcoholism, higher levels of alcohol intake and a greater number of alcohol problems in the 10 years preceding the diagnosis, and a history of drug use. Conclusions: Even in this highly educated and high-functioning group of men , alcohol abuse and dependence predicted the onset and cessation of alcohol -related problems.