Abstract
Several studies have been done on the prevalence of the alcohol dependence syndrome, while other studies have focused on whether the dependence syndrome can be seen as a unity, or not. Few studies have analysed the association between alcohol consumption, the alcohol dependence syndrome (ADS) and alcohol-related problems. A main issue is to what extent an association between alcohol consumption and problems is explained by the dependence syndrome or by its sub-components (drinking despite a health problem, craving, impaired control, preoccupation with alcohol, withdrawal symptoms and increased tolerance). The purpose in this paper is to elucidate this issue in analyses of data from the health care-based clinical sample of the study “Women and Men in Swedish Addiction Treatment”, comprising comprehensive interviews of almost 1000 inpatients and outpatients in Stockholm County. These data cover e.g. alcohol and drug use, alcohol dependence (ICD-10) measured by the Composite International Diagnostic Interview (CIDI), the composite-scores part of the Addiction Severity Index (ASI), sociodemographics and alcohol-related problems. Three measures of alcohol-related problems were constructed covering health and psychological problems, self-defined social problems, and social problems defined by others. In these exploratory analyses of patients with alcohol dependence as a dominating problem, a series of logistic regression analyses were done. A substantial part of the association between the consumption measures and the three outcomes could be accounted for by measures of the ADS. The predictive power of the six criteria composing the ADS varied considerably for the different outcomes. The interpretation is not straightforward, not least as the alcohol dependence syndrome also includes items of alcohol-related problems.