Alcohol withdrawal diagnostic criteria

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]; Kiran Singh, M.D. [3]

Overview

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria is used to diagnose alcohol withdrawal and the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-A) scale is used to assess the severity of alcohol withdrawal.

Diagnosis

DSM-V Diagnostic Criteria for Alcohol Withdrawal

“

A. Cessation of (or reduction in) alcohol use that has been heavy and prolonged. AND B. Two (or more) of the following, developing within several hours to a few days after the cessation of (or reduction in) alcohol use described in Criterion A: 1. Autonomic hyperactivity (e.g., sweating or pulse rate greater than 100 bpm). 2. Increased hand tremor. 3. Insomnia. 4. Nausea or vomiting. 5. Transient visual, tactile, or auditory hallucinations or illusions. 6. Psychomotor agitation. 7. Anxiety. 8. Generalized tonic-clonic seizures. AND C. The signs or symptoms in Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. AND D. The signs or symptoms are not attributable to another medical condition and are not better explained by another mental disorder, including intoxication or withdrawal from another substance. Specify if: With perceptual disturbances: This specifier applies in the rare instance when hallucinations(usually visual or tactile) occur with intact reality testing, or auditory, visual,

”

Clinical Institute Withdrawal Assessment for Alcohol revised (CIWA-Ar)

The CIWA (Clinical Institute Withdrawal Assessment) is a common measure used in North American hospitals to assess and treat alcohol withdrawal syndrome and for alcohol detoxification. This clinical tool assesses 10 common withdrawal signs. A score of more than 15 points is associated with increased risk of alcohol withdrawal effects such as confusion or seizures.

Alcohol withdrawal

Other Assessment Scales

Alcohol Assessment Scale

Alcohol Withdrawal Scale

Level of Evidence

Assessment Scale	Level of Evidence
The Clinical Institute Withdrawal Assessment for Alcohol Revised (CIWA-Ar)	I
Alcohol Assessment Scale (AWS)	IV