Using cluster analysis of alcohol use disorders to investigate ‘diagnostic orphans’: subjects with alcohol dependence symptoms but no diagnosis

• Published in: Drug and alcohol dependence Vol. 60; no. 3; pp. 295 - 302
• Main Authors: Sarr, Moussa, Bucholz, Kathleen K., Phelps, Deborah L.
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.11.2000; Elsevier Science
• Subjects: Addictive behaviors; Adult; Adult and adolescent clinical studies; Age Factors; Alcohol abuse; Alcohol dependence; Alcoholism; Alcoholism - diagnosis; Alcoholism and acute alcohol poisoning; Biological and medical sciences; Cluster Analysis; Dependence symptoms; Diagnosis; Diagnosis, Differential; Diagnostic and Statistical Manual 1V; Female; Follow-Up Studies; Humans; Male; Medical sciences; Nosology; Psychiatric Status Rating Scales; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Sex Factors; Symptoms; Toxicology; Alcohol dependence; Nosology; Dependence symptoms; Diagnosis; Alcohol abuse; Cluster analysis; Human; Statistical analysis; Abuse; Education level; Alcoholism; Sex; Alcoholic beverage; Symptomatology; Characteristics; Sociodemographic factor; Dependence; Race; Age
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/S0376-8716(00)00118-6

The purpose of this paper is to examine the characteristics of community subjects with one or two alcohol dependence symptoms who did not satisfy the criteria for Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) alcohol dependence or abuse (sub-diagnostic group or diagnostic orphans). Variables not included in the DSM-IV alcohol abuse and dependence criteria are used to compare the different alcohol statuses. The results indicate that the sub-diagnostic group ‘diagnostic orphans’ formed a cluster distinct from that of the non-problem drinkers group, and appeared to be closer to those with alcohol abuse than to those with alcohol dependence. 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 to 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 alcohol dependence should be considered along with alcohol abuse as an entity in future DSM classifications.