Age differences in diagnostic criteria of DSM-IV alcohol dependence among adults with similar drinking behaviour


Alexander Pabst, IFT Institut für Therapieforschung, Parzivalstraße 25, D-80804 Munich, Germany. E-mail:


Aims  To test age differences in the prevalence of DSM-IV alcohol dependence (AD) diagnostic criteria in the adult general population while controlling for drinking behaviour.

Design and setting  Cross-sectional data from the 2006 German Epidemiological Survey of Substance Abuse (ESA) were used, applying a two-stage probability sampling design. The survey used self-administered questionnaires and telephone interviews (mixed-mode design; 45% response rate).

Participants  The analytical sample consisted of n = 6984 individuals aged 18–64 years reporting alcohol consumption within the previous year.

Measurements  Age effects on individual AD criteria were estimated using logistic regression models, adjusting for eight mutually exclusive drinking groups (defined in terms of average daily alcohol intake and episodic heavy drinking) and socio-economic variables.

Findings  When controlling for drinking behaviour, 18–24-year-olds were more likely to meet the criteria ‘tolerance’, ‘larger/longer’ and ‘time spent’ relative to older age groups. In contrast, the likelihood of experiencing ‘withdrawal’ symptoms increased with age. There was no significant age effect on the diagnosis of AD.

Conclusions  Age differences in the prevalence of specific alcohol dependence diagnostic criteria such as ‘tolerance’, ‘drinking larger amount or for longer than intended’ and ‘time spent recovering’ cannot be fully explained by differences in drinking behaviour.