Three important changes to the diagnosis of substance, including alcohol, use disorders are proposed in DSM-5: (a) abuse and dependence may no longer be considered independent entities. Instead, a uni-dimensional score of 11 (abuse and dependence) criteria is proposed to diagnose moderate (2–3 criteria) and severe (4 or more criteria) substance use disorders; (b) “recurrent legal problems” may no longer be part of the criteria, due to its low frequency and weak correlation with the remaining abuse and dependence criteria; and (c) a new criterion, craving, has been suggested for addition to the existing criteria (O’Brien, 2011). While most investigators with data collected using DSM-IV criteria will experience limited problems with (a) and (b), the addition of a new criterion (c) can pose challenges for studies that have not collected data on craving. Particularly for large-scale genetic studies where it is often infeasible to conduct repeat data collection, the possibility exists that the addition of this new criterion will compromise genetic examination of the proposed DSM-5 defined substance use disorders. This report examines what additional genetic information craving contributes that cannot be gleaned from examining DSM-IV dependence criteria.
