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Lower levels of educational attainment before entry into treatment predicted shorter times to first drink and relapse in both women and men. The association of educational attainment and treatment outcome for alcohol dependence warrants further investigation.

Accurate diagnosis is crucial for both clinical work and research. In the last three decades, major strides forward have been made in the development of diagnostic categories and criteria that can improve research into etiology, prognosis, and treatment response. Yet problems persist, as evidenced in debates about the validity of various diagnoses (e.g., atypical depression), the criteria for diagnoses (e.g., the number of weeks of continuous depression required for a diagnosis of major depression, or the number of binges per week required for a diagnosis of bulimia nervosa), and the separation of clinical syndromes from personality syndromes known to predispose individuals to certain disorders (e.g., major depression and borderline personality disorder). Equally important are concerns by clinicians that the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) is cumbersome to apply and not tied closely enough to clinical decision-making.