Criteria for the diagnosis of alcoholism.

Manifestations of alcoholism in general hospital patients were studied retrospectively by review of medical records to determine their frequency of occurrence. Pathophysiological indications of alcoholism were far more commonly recorded than were behavioral or psychological changes, although most diagnostic clues were notable by their absence from a majority of the records. Optimizing the diagnostic efficacy of those features of alcoholism that did occur may require application of the methods of statistical decision making. Absence from the charts of behavioral criteria and of indications of tolerance reflects deficiencies in both patient interviewing and medical record keeping. The traditional structure of the medical history may require modification to ensure recording of these more specific manifestations. In addition, continued efforts are needed to improve the undergraduate and the direct-care education of physicians.