DSM-5-TR diagnostic criteria summary
Alcohol Use Disorder requires a problematic pattern of alcohol use leading to clinically significant impairment, with at least 2 of 11 criteria within a 12-month period:
- Alcohol taken in larger amounts or longer than intended.
- Persistent desire or unsuccessful efforts to cut down.
- Significant time spent obtaining, using, or recovering from alcohol.
- Craving or strong desire to use alcohol.
- Recurrent use causing failure to fulfill major role obligations.
- Continued use despite recurrent social/interpersonal problems.
- Important social, occupational, or recreational activities given up.
- Recurrent use in physically hazardous situations.
- Continued use despite knowledge of physical/psychological problems.
- Tolerance (need for more alcohol or diminished effect).
- Withdrawal (symptoms or alcohol used to relieve/avoid them).
Severity: Mild (2–3 criteria), Moderate (4–5 criteria), Severe (6+ criteria). The fourth-character codes specify state: F10.10 mild, F10.20 moderate-severe uncomplicated, F10.21 in remission, F10.22 with intoxication, F10.23 with withdrawal, F10.24 with mood disorder, etc.
Source: American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), p. 553–562.
Differential diagnosis
- F10.10 Alcohol Use Disorder, Mild, meeting 2–3 criteria; severity downstream affects ICD code selection.
- F10.21 Alcohol Use Disorder, In Remission, none of the criteria except craving have been met for ≥3 months.
- F10.23 Alcohol Withdrawal, autonomic hyperactivity, tremor, insomnia, nausea, transient hallucinations, anxiety, seizures within hours-to-days of cessation.
- F10.24 Alcohol-Induced Mood/Anxiety/Psychotic Disorders, symptoms develop during or shortly after intoxication or withdrawal.
- Other Substance Use Disorders, particularly co-occurring sedative-hypnotic, opioid, or stimulant use; coded separately.
- Major Depressive Disorder (F33, F32), high comorbidity; depression sometimes resolves after sustained abstinence, sometimes requires concurrent treatment.
Common comorbidities
AUD has very high lifetime comorbidity with other psychiatric conditions. Common co-occurring conditions: Major Depressive Disorder (F33, F32), Generalized Anxiety Disorder (F41.1), Post-Traumatic Stress Disorder (F43.10), Bipolar I/II (F31.x), other Substance Use Disorders, and chronic pain conditions. Co-administer the AUDIT alongside PHQ-9, GAD-7, and PCL-5 in primary care and behavioral health workflows.
Sources
- American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), F10.20, p. 553–562.
- Babor, T. F., Higgins-Biddle, J. C., Saunders, J. B., & Monteiro, M. G. (2001). AUDIT: The Alcohol Use Disorders Identification Test, Guidelines for Use in Primary Care, World Health Organization.
- Centers for Disease Control and Prevention. ICD-10-CM Official Coding Guidelines.