Alcoholism—diagnostic Criteria and Variability

Diagnosis is the process of identifying and specifying the necessary condition. In clinical research, diagnostic criteria are a set of rules needed for identification. These are important and improvement of diagnostic criteria often precedes other major advances in understanding other areas viz. aetiology and treatment. As regards diagnosis of alcoholism, there are several criteria and definitions. Some of these are for research purposes. Some for day to day clinical practice and others for screening in the community. The rules are different and only modest degree of overlap is seen. In other words, patient diagnosed to have 'alcoholism' by one criteria would not satisfy the other systems. The above mentioned points are made clearer by examining four commonly used definitions. These are : Michigan Alcoholism Screening Test (MAST) (Selzer, 1971), Diagnostic and Statistical Manual 3rd Edition (DSM III) (APA, 1980), Research Diagnostic Criteria (RDC) (Spitzer et al., 1978) and ICD-9 (WHO, 1977).