Current Addiction Reports

, Volume 5, Issue 2, pp 257–264 | Cite as

Alcohol Use Disorders in the Draft ICD-11, and How They Compare with DSM-5

  • John B. SaundersEmail author
  • Amy Peacock
  • Louisa Degenhardt
Alcohol (M Farrell and E Stockings, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Alcohol


Purpose of Review

This review examines how disorders due to alcohol are conceptualised, defined and classified in the latest draft of the Eleventh Revision of the International Classification of Diseases (ICD-11) published in November 2017. Some key diagnoses are compared with their nearest counterparts in the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Recently published papers relevant to these comparisons are highlighted.

Recent Findings

There are distinct differences between ICD-11 and DSM-5 in how they treat disorders due to alcohol, in both the diagnoses presented and their associated criteria. Shifts in the conceptualisation of substance use disorder have generated some controversy. These relate primarily to the aggregation of DSM-IV Alcohol Abuse and Alcohol Dependence to Alcohol Use Disorder in DSM-5. In the draft ICD-11, there is a simplified definition and the six diagnostic guidelines for Alcohol Dependence in ICD 10 have been combined into three. Early findings indicate high levels of agreement for the diagnosis of Alcohol Dependence in ICD-11, ICD 10 and DSM-IV, with DSM-5 Alcohol Use Disorder capturing a wider and different aspect of problematic use. The draft ICD-11 has introduced Hazardous Alcohol Use as a distinct diagnosis and details alcohol-related physical disorders, with no DSM equivalents.


Certain diagnoses are unique to a classification system, and preliminary research suggests that modifications in the latest versions may impact on concordance between the two systems in the diagnosis of alcohol use disorders, although further research assessing this across different populations is warranted.


Alcohol Use Disorder ICD 10 ICD-11 DSM-5 Alcohol Dependence Diagnosis Classification 


Funding Information

LD is supported by an Australian National Health and Medical Research Council (NHMRC) Senior Principal Research Fellowship. AP is supported by an NHMRC Early Career Fellowship. The National Drug and Alcohol Research Centre at University of New South Wales, Australia, is supported by funding from the Australian Government, under the Substance Misuse Prevention and Service Improvements Grant Fund.

Compliance with Ethical Standards

Conflict of Interest

Dr. Peacock and Dr. Degenhardt declare that they have no competing interests.

Dr. Saunders has contributed to the development of the DSM and ICD systems since 1987. He was a member of the Advisory Panel for the development of DSM-IV (from 1988 to 1994) and was Co-Chair of the Research Advisory Committee for DSM-5 from 2003 to 2008; he was not a member of the Editorial Group for DSM-5. He was a member of the Psychoactive Substance Use Disorders Workgroup for the development of ICD 10 from 1987 to 1994. He was involved in developing and revising the ICD 10 Clinical Descriptions and Diagnostic Guidelines and was subsequently responsible for developing the corresponding ICD 10 Diagnostic Criteria for Research. He is currently a member of the Substance Use and Related Disorders Work Group for ICD-11. In these capacities, he has received travel support to attend meetings and fees and per diem allowances from the American Psychiatric Association and the World Health Organization.


The opinions stated in this paper are those of the authors and do not represent endorsement from the American Psychiatric Association or the World Health Organization.

Human and Animal Rights

All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards and international/national/institutional guidelines).


Papers of particular interest, published recently, have been highlighted as: •• Of major importance

  1. 1.
    World Health Organization. International guide for monitoring alcohol consumption and related harm. 2000. Retrieved from
  2. 2.
    World Health Organization. 11th Revision of the International Classification of Diseases. Geneva: World Health Organization; 2017.Google Scholar
  3. 3.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: American Psychiatric Association; 2013.CrossRefGoogle Scholar
  4. 4.
    American Society of Addiction Medicine. Definition of addiction. 2011
  5. 5.
    Saunders JB, Latt NC. Diagnosis and classification of substance use disorders. In: Johnson BA, editor. Addiction medicine: science and practice. New York: Springer; 2011. p. 95–113.Google Scholar
  6. 6.
    Saunders JB. Substance use and addictive disorders in DSM-5 and ICD 10 and the draft ICD 11. Curr Opin Psychiatry. 2017;30(4):227–37.CrossRefPubMedGoogle Scholar
  7. 7.
    Pull CB, Saunders JB, Mavreas V, Cottler LB, Grant BF, Hasin DS, et al. Concordance between ICD 10 alcohol and drug use disorder criteria and diagnoses as measured by the AUDADIS-ADR, CIDI and SCAN: results of a cross-national study. Drug Alcohol Depend. 1997;47(3):207–16.CrossRefPubMedGoogle Scholar
  8. 8.
    Hasin D. Classification of alcohol use disorders. Alcohol Res Health. 2003;27(1):5–17.PubMedGoogle Scholar
  9. 9.
    Jason B, Ye Y, Cherpitel CJ, Borges G, Cremonte M, Moskalewicz J, et al. Scaling properties of the combined ICD 10 dependence and harms criteria and comparisons with DSM-5 alcohol use disorder criteria among patients in the emergency department. J Stud Alcohol Drugs. 2012;73(2):328–36.CrossRefPubMedCentralGoogle Scholar
  10. 10.
    Witkiewitz K, Hallgren KA, O’Sickey AJ, Roos CR, Maisto SA. Reproducibility and differential item functioning of the alcohol dependence syndrome construct across four alcohol treatment studies: an integrative data analysis. Drug Alcohol Depend. 2016;158:86–93.CrossRefPubMedGoogle Scholar
  11. 11.
    Saunders JB. Rationale for changes in the clinical descriptions and diagnostic guidelines of disorders due to substance use and related conditions in the draft ICD 11. Presented at the World Congress of the World Psychiatric Association, Madrid, Spain, September 2014. Geneva: Department of Mental Health and Substance Abuse, WHO; 2014.Google Scholar
  12. 12.
    Poznyak V. An update on ICD-11 taxonomy of disorders due to psychoactive substance use and related health conditions. WHO-ISBRA Symposium on Alcohol and Drug Diagnoses in the International Classification of Diseases, ISBRA-ESBRA Joint Congress, Berlin, Germany; 2016.Google Scholar
  13. 13.
    Yoshimura A, Komoto Y, Higuchi S. Exploration of core symptoms for the Diagnosis of Alcohol Dependence in the ICD 10. Alcohol Clin Exp Res. 2016;40(11):2409–17.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    •• Lago L, Bruno R, Degenhardt L. Concordance of ICD-11 and DSM-5 definitions of alcohol and cannabis use disorders: a population survey. Lancet Psychiatry. 2016;3(7):673–84. Key identified study comparing current iterations of DSM and ICD. CrossRefPubMedGoogle Scholar
  15. 15.
    Saha TD, Chou SP, Grant BF. Toward an alcohol use disorder continuum using item response theory: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Psychol Med. 2006;36(7):931–41.CrossRefPubMedGoogle Scholar
  16. 16.
    Bartoli F, Carrà G, Crocamo C, Clerici M. From DSM-IV to DSM-5 alcohol use disorder: an overview of epidemiological data. Addict Behav. 2015;41:46–50.CrossRefPubMedGoogle Scholar
  17. 17.
    Ehlers CL, Stouffer GM, Corey L, Gilder DA. The clinical course of DSM-5 alcohol use disorders in young adult native and Mexican Americans. Am J Addict. 2015;24(8):713–21.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Baggio S, Studer J, Dupuis M, Gerhard G. Subthreshold problem drinkers in DSM-5 alcohol use disorder classification. Am J Addict. 2016;25(5):408–15.CrossRefPubMedGoogle Scholar
  19. 19.
    •• Slade T, Chiu WT, Glantz M, Kessler RC, Lago L, Sampson N, et al. A cross-national examination of differences in classification of lifetime alcohol use disorder between DSM-IV and DSM-5: findings from the World Mental Health Survey. Alcohol Clin Exp Res. 2016;40(8):1728–36. Key identified study comparing current and past iterations of DSM. CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association; 2000.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • John B. Saunders
    • 1
    • 2
    Email author
  • Amy Peacock
    • 3
    • 4
  • Louisa Degenhardt
    • 3
  1. 1.Centre for Youth Substance Abuse ResearchUniversity of QueenslandBrisbaneAustralia
  2. 2.Disciplines of Psychiatry and Addiction Medicine, Faculty of MedicineUniversity of SydneySydneyAustralia
  3. 3.National Drug and Alcohol Research CentreUniversity of New South WalesSydneyAustralia
  4. 4.School of Medicine (Psychology)University of TasmaniaHobartAustralia

Personalised recommendations