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      Epidemiology of DSM-5 Alcohol Use Disorder : Results From the National Epidemiologic Survey on Alcohol and Related Conditions III

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          Abstract

          IMPORTANCE

          National epidemiologic information from recently collected data on the new DSM-5 classification of alcohol use disorder (AUD) using a reliable, valid, and uniform data source is needed.

          OBJECTIVE

          To present nationally representative findings on the prevalence, correlates, psychiatric comorbidity, associated disability, and treatment of DSM-5 AUD diagnoses overall and according to severity level (mild, moderate, or severe).

          DESIGN, SETTING, AND PARTICIPANTS

          We conducted face-to-face interviews with a representative US noninstitutionalized civilian adult (≥18 years) sample (N = 36 309) as the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions III (NESARC-III). Data were collected from April 2012 through June 2013 and analyzed in October 2014.

          MAIN OUTCOMES AND MEASURES

          Twelve-month and lifetime prevalences of AUD.

          RESULTS

          Twelve-month and lifetime prevalences of AUD were 13.9% and 29.1%, respectively. Prevalence was generally highest for men (17.6% and 36.0%, respectively), white (14.0% and 32.6%, respectively) and Native American (19.2% and 43.4%, respectively), respondents, and younger (26.7% and 37.0%, respectively) and previously married (11.4% and 27.1%, respectively) or never married (25.0% and 35.5%, respectively) adults. Prevalence of 12-month and lifetime severe AUD was greatest among respondents with the lowest income level (1.8% and 1.5%, respectively). Significant disability was associated with 12-month and lifetime AUD and increased with the severity of AUD. Only 19.8% of respondents with lifetime AUD were ever treated. Significant associations were found between 12-month and lifetime AUD and other substance use disorders, major depressive and bipolar I disorders, and antisocial and borderline personality disorders across all levels of AUD severity, with odds ratios ranging from 1.2 (95% CI, 1.08-1.36) to 6.4 (95% CI, 5.76-7.22). Associations between AUD and panic disorder, specific phobia, and generalized anxiety disorder were modest (odds ratios ranged from 1.2 (95% CI, 1.01-1.43) to 1.4 (95% CI, 1.13-1.67) across most levels of AUD severity.

          CONCLUSIONS AND RELEVANCE

          Alcohol use disorder defined by DSM-5 criteria is a highly prevalent, highly comorbid, disabling disorder that often goes untreated in the United States. The NESARC-III data indicate an urgent need to educate the public and policy makers about AUD and its treatment alternatives, to destigmatize the disorder, and to encourage those who cannot reduce their alcohol consumption on their own, despite substantial harm to themselves and others, to seek treatment.

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          Author and article information

          Journal
          101589550
          40869
          JAMA Psychiatry
          JAMA Psychiatry
          JAMA psychiatry
          2168-622X
          2168-6238
          3 October 2016
          August 2015
          17 January 2017
          : 72
          : 8
          : 757-766
          Affiliations
          Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland (Grant, Goldstein, Saha, Chou, Jung, Zhang, Pickering, Ruan, Smith, Huang); Department of Psychiatry, College of Physicians and Surgeons, Mailman School of Public Health, Columbia University, New York, New York (Hasin); New York State Psychiatric Institute, New York (Hasin).
          Author notes
          Corresponding Author: Bridget F. Grant, PhD, Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 5635 Fishers Ln, Room 3077, Rockville, MD 20852 ( bgrant@ 123456mail.nih.gov ).
          Article
          PMC5240584 PMC5240584 5240584 nihpa818095
          10.1001/jamapsychiatry.2015.0584
          5240584
          26039070
          a438ca22-bc3b-49b1-a679-2bc8e32fe7a9
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