The DSM-III diagnosis of alcohol use disorders in women: findings from a follow-up study of 44 female alcoholics.

In a long term follow-up study of 44 young women with symptoms of alcohol dependence at index year, only 17 (38%) of the interviewed subjects fulfill the DSM-III criteria for alcohol abuse or dependence the year prior to follow-up according to the interview material. The reason for this is partly that there has been a change in drinking patterns for 24 women (54%), of which eight are abstainers, seven asymptomatic drinkers and nine having an increased tolerance as the only sign of a possibly pathological alcohol use. Partly, however, the lack of diagnosis can be attributed to client denial or substituting drugs for alcohol, and partly due to inadequate criteria. Some of the DSM-III criteria are sex biased, probably leading to men having a diagnosis at an earlier stage of alcoholism. The concept of degree of alcohol dependence, an appropriate time limit for assessment of diagnosis and the difference between primary and secondary alcoholism, should be specified in future diagnostic criteria for alcohol use disorders.