Diagnostic challenges in alcohol use disorder and alcoholic liver disease

Table 1 Diagnostic and Statistical Manual of Mental Disorders-5 criteria for alcohol use disorders

Criterion	Group
1	Impaired control	The individual may take alcohol in larger amounts or over a longer period than was originally intended
2		The individual may express a persistent desire to cut down or regulate alcohol use and may report multiple unsuccessful efforts to decrease or discontinue use
3		The individual may spend a great deal of time obtaining alcohol, drinking alcohol, or recovering from its effects
4		Craving is manifested by an intense desire or urge for alcohol that may occur at any time but is more likely when in an environment where alcohol previously was obtained or used
5	Social impairment	Recurrent alcohol use may result in a failure to fulfil major role obligations at work, school, or home
6		The individual may continue alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol use
7		Important social, occupational, or recreational activities may be given up or reduced because of alcohol use. The individual may withdraw from family activities and hobbies in order to use alcohol
8	Risky use	This may take the form of recurrent alcohol use in situations in which it is physically hazardous
9		The individual may continue alcohol use despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol
10	Pharmacological criteria	Tolerance, as defined by a need for a markedly increased dose of alcohol to achieve the desired effect or by a markedly reduced effect when the usual dose is consumed
11		Withdrawal, that is a syndrome that occurs when blood or tissue concentrations of alcohol decline in an individual who had maintained prolonged heavy alcohol use