Rosh Psychiatry Board Practice Exam

A man with a history of alcohol use disorder has been abstinent for six months. What is the most accurate diagnosis?

1. Alcohol abuse in early remission

2. Severe alcohol use disorder in early remission

3. Severe alcohol use disorder in sustained remission

4. Alcohol abuse in sustained remission

The correct answer is: Severe alcohol use disorder in early remission

The correct diagnosis for a man with a history of alcohol use disorder who has been abstinent for six months is severe alcohol use disorder in sustained remission. In the diagnostic criteria for substance use disorders, specifically alcohol use disorder, remission is categorized into early and sustained periods depending on the length of abstinence. Early remission is defined as at least three but less than 12 months of abstinence. Sustained remission, on the other hand, is defined as a period of 12 months or more of abstinence. Since the man has been abstinent for six months, he falls under early remission. However, the diagnosis must also consider the severity of the disorder. The term "severe" is used when the individual has met at least six of the criteria outlined in the DSM-5 for alcohol use disorder. If the man has a history of severe alcohol use disorder and has maintained his abstinence for a period that qualifies for early remission, then the appropriate diagnosis would reflect both his history and current status. Thus, while the individual is in early remission, the correct diagnosis acknowledges the severity of his prior use, leading to the conclusion that "severe alcohol use disorder in early remission" is the most accurate diagnosis given the details.