Two Alcoholisms: Abuse And Dependence: Nosology issues from the Epidemiological studies of Alcoholism in Korea

Abstract

This article, (1) reviews nosological issues of the distinction between alcohol abuse and alcohol dependence; (2) discusses the Korean epidemiological trends of alcohol abuse and alcohol dependence. Psychiatric epidemiological studies of Korean population that provided clues to the validity and cross-cultural applicability of alcohol abuse and alcohol dependence were reviewed. Alcohol use disorder has been the most common mental disorder in Korea. However, during the last 20 years, the prevalence rates of the two alcohol use disorders have grown in opposite directions. The lifetime prevalence rate of alcohol abuse has fallen from 12.06% to 7.11%, conversely, the lifetime prevalence rate of alcohol dependence has slightly increased from 9.92% to 10.20%. Nosological issues, such as the vulnerability of alcohol abuse to social environments, the hierarchical structure of the DSM-IV and the prevailing Korean concepts of abuse and dependence, were reviewed as factors to be considered in explaining these findings. Alcohol dependence outranks alcohol abuse and is now the main alcohol use disorder in Korea. But, there are still nosological issues that need to be assessed and considered, such as the validity of alcohol dependence in subpopulations and the heterogeneity of the DSM-IV alcohol dependence category.