A unique strength of this study is that it compared DSM-IV and DSM-5 criteria in a clinical sample of heavy drinkers. This is an important population to study because it is these patients in whom assessments for AUD are used clinically. It is not possible to determine the extent to which the higher prevalence of AUD using DSM-5 criteria (85.9%) compared to DSM-IV criteria (73.3%) is due to the specific characteristics of the sample we studied—primary care patients who reported frequent binge drinking—or if this result would be found in more general clinical populations. However, this study’s finding that a sizable group of patients (13%) met criteria for DSM-5 AUD alone is consistent with 7 of 12 recent studies comparing the prevalence of AUD based on DSM-IV and DSM-5 criteria in mostly non-clinical settings [12]. The fact that only one patient met criteria for DSM-IV AUD alone might be somewhat surprising. One might have expected more than 1 patient with frequent binge drinking to meet the DSM-IV AUD criteria with just 1 DSM-IV abuse criterion or 2 DSM-IV criteria that
