The concept of alcohol dependence syndrome (WHO, 1977) incorporates psychological dependence (alteration of behavioural state and subjective mental state) into the structure of the syndrome. This has influenced DSM-III, III-R, IV, and ICD-10. In these diagnostic criteria, the presence of psychological dependence is necessary to diagnose alcohol dependence. Medical care for alcohol dependence syndrome is insufficient in Japan. In a recent report, less than 10% of patients with alcohol dependence (ICD-10) had been diagnosed and were receiving medication in Japan. DSM-5 proposes diagnostic criteria for alcohol use disorder that integrates concepts of abuse and dependence on alcohol. The threshold level of DSM-5 criteria for alcohol use disorder is lower than those for alcohol dependence of DSM-IV and ICD-10. With the changes in the diagnosis, moderation of the consumed amount of alcohol, not just complete abstinence, has gained been gaining recognition as the treatment goal, and brief intervention has recently been suggested to be useful for the disorder. The prognosis of patients with depression and anxiety disorder comorbid with mild alcohol use disorder has been reported to be poor, so paying attention to the presence of mild alcohol use disorder, which lies behind depression and anxiety disorder, is essential.
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