In this sample of VA primary care patients at high risk for AUD due to frequent binge drinking, DSM-5 AUD criteria identified about 13% more patients with AUD than DSM-IV criteria. Almost three quarters of patients met both DSM-IV and DSM-5 criteria for AUD and 14% met criteria for neither, but only one patient out of 304 met criteria for DSM-IV AUD but not DSM-5 AUD. Moreover, in this sample of primary care patients recruited for a trial of care management for patients at high risk for AUD, there were marked differences in the clinical characteristics across the four groups. Those who met both DSM-IV and DSM-5 AUD criteria not only had more negative consequences due to drinking, but also more mental health and drug use symptoms and greater reported readiness to change compared with those who met either DSM-IV or DSM-5 AUD alone, and those who met neither DSM-IV nor DSM-5 criteria for AUD.
