Primary mental disorders
Alcohol-Induced Disorders may be characterized by symptoms (e.g., depressed mood) that resemble primary mental disorders (e.g., Major Depressive Disorder versus Alcohol-Induced Mood Disorder, With Depressive Features, With Onset During Intoxication).
General medical conditions
The incoordination and impaired judgement that are associated with Alcohol Intoxication can resemble the symptoms of certain general medical conditions (e.g., diabetic acidosis, cerebellar ataxias, and other neurological conditions such as multiple sclerosis). Similarly, the symptoms of Alcohol Withdrawal can also be mimicked by certain general medical conditions (e.g., hypoglycemia and diabetic ketoacidosis). Essential tremor, a disorder that frequently runs in families, may suggest the tremulousness associated with Alcohol Withdrawal.
Alcohol Intoxication (except for the smell of alcohol on the breath) closely resembles Sedative, Hypnotic, or Anxiolytic Intoxication. The presence of alcohol on the breath does not by itself exclude intoxications with other substances because multiple substances are not uncommonly used concurrently. Although intoxication at some time during their lives is likely to be a part of the history of most individuals who drink alcohol, when this phenomenon occurs regularly or causes impairment it is important to consider the possibility of a diagnosis of Alcohol Dependence or Alcohol Abuse. Sedative, Hypnotic, or Anxiolytic Withdrawal produces a syndrome very simlilar to that of Alcohol Withdrawal.
Other Alcohol-Related Disorders
Alcohol Intoxication and Alcohol Withdrawal are distinguished from the other Alcohol-Induced Disorders (e.g., Alcohol-Induced Anxiety Disorder, With Onset During Withdrawal) because the symptoms in these latter disorders are in excess of those usually associated with Alcohol Intoxication or Alcohol Withdrawal and are severe enough to warrant independent clinical attention. Alcohol idiosyncratic intoxication, defined as marked behavioral change, usually aggressiveness, following the ingestion of a relatively small of amount of alcohol, was included in DSM-III-R. Because of limited support in the literature for the validity of this condition, it is no longer included as a separate diagnosis in DSM-IV. Such presentations would most likely be diagnosed as Alcohol Intoxication or Alcohol-Related Disorder Not Otherwise Specified.