of the other substance use disorders, reflecting  the need to identify only cases that have
sufficient clinical importance to warrant the la beling of a mental disorder. A key goal of in-
cluding caffeine use disorder in  this section of DSM-5 is to stimulate research that will
determine the reliability, validity, and preval ence of caffeine use disorder based on the
proposed diagnostic schema, with particular attention to the association of the diagnosis
with functional impairments as part of validity testing. 
The proposed criteria for caff eine use disorder reflect the need for a diagnostic thresh-
old higher than that used for the other subs tance use disorders. Such a threshold is in-
tended to prevent overdiagnosis of caffeine us e disorder due to the high rate of habitual
nonproblematic daily caffeine use in the general population. 
Diagnostic Features
Caffeine use disorder is characterized by the continued use of caffeine and failure to con-
trol use despite negative physical and/or psyc hological consequences. In a survey of the
general population, 14% of caffeine users met the criterion of use despite harm, with most
reporting that a physician or counselor had advised them to stop or reduce caffeine use
within the last year. Medical and psychological problems attributed to caffeine included
heart, stomach, and urinary problems, and co mplaints of anxiety, depression, insomnia,
irritability, and difficulty thinking. In the sam e survey, 45% of caffei ne users reported de-
sire or unsuccessful efforts to control caffeine use, 18% repo rted withdrawal, 8% reported
tolerance, 28% used more than intended, and 50% reported spending a great deal of time
using caffeine. In addition, 19% reported a strong desire for caffeine that they could not re-