DSM-5 latent classes of alcohol users in a population-based sample: Results from the São Paulo Megacity Mental Health Survey, Brazil

Abstract

Background We aimed to identify different categorical phenotypes based upon the DSM-V criteria of alcohol use disorders (AUD) among alcohol users who had at least one drink per week in the past year (n = 948). Methods Data are from the São Paulo Megacity Mental Health Survey collected in 2005–2007, as part of the World Mental Health Survey Initiative. A latent class analysis of the 11 DSM-5-AUD criteria was performed using Mplus, taking into account complex survey design features. Weighted logistic regression models were used to examine demographic correlates of the DSM-5-AUD latent classes. Results The best latent-class model was a three-class model. We found a “non-symptomatic class” (69.7%), a “use in larger amounts class” (23.2%), defined by high probability (>70%) of the “use in larger amounts” criterion only, and a “high-moderate symptomatic class” (7.1%), defined by high-moderate probability of all the 11 AUD criteria. Compared to those in the non-symptomatic class, individuals in the “high-moderate symptomatic class” were more likely to have been married, have lower educational attainment and to be unemployed or in non-regular/informal employment. Those on the “use in larger amounts class” were more likely to have been married or never married. Conclusion The two symptomatic classes clearly represented the dimensionality of the new proposed AUD criteria, and could be more specifically targeted by different prevention or treatment strategies. DSM-5-AUD has the advantage of shedding light on risky drinkers included in the “use in larger amounts class”, allowing for preventive interventions, which will reach a large number of individuals.

Investigating dimensionality and measurement bias of DSM-5 alcohol use disorder in a representative sample of the largest metropolitan area in South America

“…The current analyses were restricted to 948 subjects who endorsed drinking at least 1 drink per week in the past year. This sub-sample was chosen because of the low drinking levels in South America (Rehm et al, 2003; Castaldelli-Maia et al, 2014). If we have chosen the past-year drinking sub-sample, we would find a very low prevalence of DSM-5 AUD criteria endorsement.…”

“…Eleven dichotomous variables matching the DSM-5 criteria were generated from these questions. The abbreviation of the names of the DSM-5 11 criteria was based upon previously published studies (Hasin et al, 2009; Shmulewitz et al, 2010; Saha et al, 2006; Castaldelli-Maia et al, 2014) as follows: Tolerance, Withdrawal, Larger/Longer, Quit/Control, Time Spent, Activities Given Up, Physical/Psychological, Neglect Roles, Social/Interpersonal, Hazardous Use and Craving.…”

Tradução, adaptação cultural e validação da questão-chave para rastreamento do uso de risco de álcool para o português

“…Uma dessas medidas é a educação em saúde para um consumo de baixo risco, prevenindo transtornos relacionados ao uso de álcool, já que, na atualidade, dada a variedade dos padrões de ingestão de álcool, não há como somente classificar os indivíduos como dependentes de álcool/alcoolistas e não dependentes (Castaldelli-Maia et al, 2014). Pois, o consumo de baixo risco popularmente conhecido como "beber social" ou "beber moderado" está permeado no senso comum por questões históricas e socioculturais que dificultam o estabelecimento de um parâmetro de limite entre o beber de baixo e alto risco que seja perceptível para a população (Junqueira, 2010).…”

Investigação de critérios diagnósticos utilizados no transtorno do uso de nicotina do DSM-5 em indivíduos da Área Metropolitana de São Paulo

“…The ICD-10 section of the survey provided the ninth item, Craving, also assessed as ever experiencing this criterion over the lifetime. The names of the criteria were based on previous studies [22,34].…”

“…The following socio-demographic correlates were considered: gender, age (categorized as [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54] and 55 years or more); education (0-4, 5-8, 9-11, 12 years or more, respectively defined as low, low-average, high-average, and high); marital status (married/cohabiting, previously married [separated/divorced/widowed], never married); employment (working/student, homemaker, retired, unemployed/other);…”