Most studies investigating the course of alcohol use disorders involve clinical samples. In this study, researchers from the Netherlands studied the course in the general population. Using data from a cohort study on mental health, researchers analyzed the prevalence, remission, and relapse rates of alcohol use disorders over 3 years in 4214 people. Diagnoses were classified according to the Diagnostic and Statistical Manual IV (DSM-IV), International Classification of Diseases 10 (ICD-10) and the craving withdrawal model (CWM).*

• Rates of remission (full or partial) from baseline to the 3-year follow-up were high: 79 to 92 percent for alcohol abuse/harmful use** and 69 to 74 percent for alcohol dependence.
• Rates of relapse were low: 0 to 14 percent of subjects with remitted alcohol abuse/harmful use or dependence at year 1 relapsed by year 3.
• About 1 to 5 percent of subjects with alcohol abuse/harmful use at baseline developed dependence by year 3.
• Results did not significantly differ across the diagnostic classification systems.

Comments by Peter Friedmann, MD, MPH:

In a general population sample, alcohol use disorders have a favorable prognosis and may lack the chronic relapsing nature seen in treatment samples. These findings suggest that a substantial population of patients with alcohol use disorders could respond to brief or minimal interventions in primary care or other nonspecialty settings.

*An alternative classification that tries to address some potential disadvantages of the DSM-IV

**Harmful use is a classification in the ICD-10; it is similar to a DSM-IV diagnosis of alcohol abuse but does not include having alcohol-related social consequences as a criteria. For more information on alcohol definitions, see http://www.bu.edu/act/alcoholandhealth/alcdefinitions.html.

Reference:

de Bruijn C, van den Brink W, de Graaf R, et al. The three year course of alcohol use disorders in the general population: DSM-IV, ICD-10 and the Craving Withdrawal Model. Addiction. 2006;101(3):385–392.

Reprinted with permission from Alcohol and Health: Current Evidence.