Strengths of the NESARC-III include its large sample size, reliable and valid measures of AUD and other psychopathology, and rigorous study methods. The NESARC-III is also unique in providing current, comprehensive information on DSM-5 AUD and its correlates and comorbidity in the United States. Potential study limitations include differences in some aspects of survey methods between the 2001-2002 NESARC and the 2012-2013 NESARC-III and less than ideal reliability for a few diagnoses other than AUD. Lifetime comorbid associations with AUD may be subject to recall bias and bias in variation of associations by ages at onset of comorbid disorders. However, these concerns are not relevant to 12-month comorbidity associations that demonstrated similar direction and magnitude as comorbid lifetime associations. Similarly to other large US surveys, we did not assess all psychiatric disorders. Because some population segments were not covered (ie, homeless individuals, prisoners, and most treated individuals), estimates presented herein may underestimate the true prevalence of AUD. The NESARC-III was also cross-sectional. Longitudinal surveys are needed to further investigate the relationships found herein and their stability in the general population.
