DSM-5 criteria were intended to result in an overall prevalence of AUD similar to the prevalence of AUD determined from DSM-IV criteria [8]. A recent review found 12 studies that compared the prevalence of AUD based on DSM-IV and DSM-5 criteria [12]. Seven of the studies showed an increase in prevalence of AUD based on DSM-5 compared to DSM-IV, and the authors of the review concluded that DSM-5 “inflated” rates of AUD [12]. However, only one of the studies reviewed included a medical sample—patients seeking care in an emergency department. In contrast, the prevalence of AUD using DSM-5 criteria was found to be lower compared to DSM-IV criteria among high-risk Swiss young men [13] and in a large cross-national sample from the World Health Organization’s World Mental Health Survey Initiative [14]. None of these studies were restricted to primary care patients and clinical samples could differ (e.g. have more severe AUD) which could decrease the impact of the shift from DSM-IV to DSM-5.
