The primary role of the DSM-5 diagnostic criteria is to guide competent clinicians in the diagnosis of their clients’ mental disorders, which would then form part of a case assessment. This would lead to a complete and informed treatment strategy for every individual patient. The diagnostic criteria contain sets of symptoms purposed to summarize characteristic syndromes of signs and symptoms indicating an underlying disorder. The DSM-5 combines alcohol abuse and alcohol dependence into a single disorder known as alcohol use disorder (AUD) having mild, moderate as well, as severe sub-classifications. The objective of this paper is to review alcohol use disorder listed in the diagnostic criteria and address the different components of differential diagnosis needed to rule it out. Different assessments required in ruling out other mental health or medical disorders with similar symptoms are addressed.
Alcohol Use Disorder (AUD)
The AUD is one of the most common mental health addictive disorders leading to illnesses and even death. The DSM-5 diagnostic criteria has integrated into a single diagnosis of alcohol use disorder based on eleven signs and symptoms. The occurrence of at least two or more of these symptoms indicates the presence of AUD, the severity of which is categorized as mild, moderate, or severe. Mild AUD happens when there are two to three symptoms. On the other hand, moderate occurs in the presence of four to five symptoms and severe occurs when there are six or more of the symptoms (American Psychiatric Association, 2013).
Alcoholism could present with a myriad of symptoms of intoxication and withdrawal exhibited by other mental disorders. Consequently, it is of greatest significance for the clinician to develop a differential diagnosis to address the root problem and avoid misdiagnosis. The first step is to rule malingering disorders, followed by substance etiology disorders. After that, the clinician rules out disorders caused by general medical conditions, then determine the particular primary disorders. Following this, a differentiation between adjustment disorders from residual ones is made to make a differential diagnosis (American Psychiatric Association, 2013).
Some of the differential diagnoses of alcohol use disorder include bipolar disorder. In fact, the majority of people diagnosed with substance abuse disorder present with this condition. Other diagnoses include panic disorder, dysthymic disorder, mania and major depression. This is usually the case as the alcohol abuse might be a reflection of self-treatment for these conditions. Also, consider the possibility of post-traumatic stress disorder. Comorbid disorders such as anxiety, depression, and antisocial behaviors are present in persons having the alcohol use disorder (Hezler & Przybeck, 2008).
Some of the assessments that can be used in ruling out other mental health or medical disorders that might present with similar concerns include the following. A thorough health history, including family history and medical history would help in identifying other conditions the person could be suffering. Moreover, a head to toe physical examination needs to be done to assess the functioning of other body systems. It is essential to perform a detailed mental status examination on the patient to rule out other mental conditions (Preisig & Fenton, 2010).
After the alcohol use disorder is established, further supportive diagnostic evaluations need to be carried out to assess the extent of bodily and organ damage from alcohol. These tests include liver functional tests to assess liver cirrhosis. The patient’s presentation of the symptoms of alcohol use disorder would aid in classifying the severity of the disorder into mild, moderate or severe. Other supportive assessments include liver hormonal assays and bilirubin level tests (Hezler & Przybeck, 2008).
In conclusion, it is evident that the new DSM-5 diagnostic criteria is an excellent tool for clinicians in diagnosing mental health disorders. Patients are better diagnosed, thus reducing the chances of misdiagnosis, just like the way the alcohol use disorder is well diagnosed.