This paper discusses the influence on daily clinical practice of the revision of the DSM-5 diagnostic criteria regarding the alcohol-related disorders. The DSM-5 new diagnostic criteria, substance use disorders (SUDs), have combined dependence criteria and three of the abuse criteria (hazardous use, neglect of major roles, and social/interpersonal problems related to use) into one disorder and added the criterion of craving. This revision increased the clinical significance of social disturbance in the DSM-5 criteria compared with that of the DSM-IV-TR. In addition, in the DSM-IV criteria, dependence was diagnosed when three or more of seven diagnostic criteria were met; whereas, in the DSM-5 criteria, two or more of eleven SUDs criteria are required for diagnosis. Therefore, the diagnostic threshold of DSM-5 was decreased in comparison with that of DSM-IV. This revision of DSM-5 has provoked concern or criticism that the DSM-5 criteria is at risk of producing a considerable number of false positives, (i.e. patients at low severity levels are not true cases). Alternatively, newly set DSM-5 diagnostic thresholds provide the opportunity for milder cases to benefit from early intervention. Considering an increase in the prevalence of patients with SUDs under the DSM-5 criteria, the development of effective auxiliary measures for diagnosis, as well as effective early intervention, are required.
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