Both HADS and BDI are valid screening instruments for the diagnosis depression in ESRD patients but there is no statistical difference found between both rating scales.
There is ongoing debate regarding the validity of the distinction of alcohol abuse and dependence, the distinction between normality and alcohol abuse, and the absence of craving in the DSM-IV classification of alcohol use disorders. In this study, we examine the discriminant validity of the DSM-IV alcohol use disorder diagnoses in three different populations (98 patients from an alcohol treatment service, 68 nontreatment-seeking heavy drinkers, and 75 psychiatric outpatients). We compare the results of the DSM-IV classification with an alternative classification that requires craving and withdrawal for the diagnosis of dependence and at least two DSM-IV abuse-dependence symptoms for the diagnosis of abuse: the Craving Withdrawal Model (CWM). Although the total prevalence of any alcohol use disorder did not differ between DSM-IV and CWM, the distinction between normality and abuse and between abuse and dependence was better for the CWM categories.
In several European countries, drivers under influence (DUI), suspected of an alcohol use disorder (AUD, 'alcoholism') are referred for diagnostic examination. The accuracy of diagnostic procedures used in diagnosing AUD in the DUI population is unknown. The aim of this study was to compare three prevalence estimates of AUD based on a structured clinical interview (SCID), a restrictive diagnostic procedure (RDP) and usual clinical diagnostic procedure (CDP), with a prevalence estimate based on sensitivity and specificity data of biological markers of excessive use of alcohol in non-judicial samples. The latter unbiased estimate provides an external yardstick against which the biased patient-based prevalence estimates in this special sample can be evaluated. The unbiased estimate derived from sensitivity and specificity data resulted in a prevalence estimate of excessive use of alcohol between 74 and 82%, which is much higher than the three diagnostic procedures. SCID identified maximally 5% of alcoholics found with the unbiased estimate. RDP identified > or =31% of the unbiased estimate, while CDP identified > or =60% of the unbiased estimate. The high chance of false positive diagnosis, however, makes CDP unacceptable in the legal context of AUD diagnosis in DUI populations.
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