Table 1.

DSM-5 Caffeine Use Disorder Research Diagnosis^a,b

A problematic pattern of caffeine use leading to clinically significant impairment or distress, as manifested by at least the first three of the following criteria occurring within a 12-month period:

1. A persistent desire or unsuccessful efforts to cut down or control caffeine use.

2. Continued caffeine use despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by caffeine.

3. Withdrawal, as manifested by either of the following:

a. The characteristic withdrawal syndrome for caffeine.

b. Caffeine (or a closely related substance) is taken to relieve or avoid withdrawal symptoms.

4. Caffeine is often taken in larger amounts or over a longer period than was intended.

5. Recurrent caffeine use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated tardiness or absences from work or school related to caffeine use or withdrawal).

6. Continued caffeine use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of caffeine (e.g., arguments with spouse about consequences of use, medical problems, cost).

7. Tolerance, as defined by either of the following:

a. A need for markedly increased amounts of caffeine to achieve desired effect.

b. Markedly diminished effect with continued use of the same amount of caffeine.

8. A great deal of time is spent in activities necessary to obtain caffeine, use caffeine, or recover from its effects.

9. Craving or a strong desire or urge to use caffeine.

Instructions for specifying severity of DSM-5 Substance Use Disordersc

Substance Use Disorders occur in a broad range of severity, from mild to severe, with severity based on the number of symptom criteria endorsed. As a general estimate of severity, a mild substance use disorder is suggested by the presence of two to three symptoms, moderate by four to five symptoms, and severe by six or more symptoms.

^aReprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (Copyright 2013). American Psychiatric Association.

^bThe DSM-5 proposed diagnostic criteria for Caffeine Use Disorder overlap considerably with the DSM-IV diagnostic criteria for Substance Dependence and Substance Abuse. Specifically, the DSM-IV diagnostic criteria for Substance Dependence include six of the above criteria (i.e., criteria 1, 2, 3, 4, 7, and 8) along with a seventh criterion not included in the Caffeine Use Disorder diagnostic schema (i.e., “important social, occupational, or recreational activities are given up or reduced because of substance use”). The DSM-IV diagnostic criteria for Substance Abuse include two of the above criteria (i.e., criteria 5 and 6) along with two other criteria not included in the Caffeine Use Disorder diagnostic schema (i.e., “recurrent substance use in situations in which it is physically hazardous” and “recurrent substance-related legal problems”). One Caffeine Use Disorder diagnostic criterion (criterion 9) is not listed in the DSM-IV diagnostic schemas for Substance Dependence or Substance Abuse.

^cThese DSM-5 instructions are for scoring severity of Substance Use Disorders. They are not listed with the proposed diagnostic criteria for Caffeine Use Disorder.