The Spanish Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS): reliability and concordance with clinical diagnoses in a Hispanic population.

200

201

Background-Item response theory (IRT) was used to determine whether DSM-IV alcohol abuse and dependence and consumption criteria were arrayed along a continuum of severity.Methods-Data came from a large, nationally representative sample of the U.S. adult population.Results-DSM-IV alcohol abuse and dependence criteria formed a continuum of alcohol use disorder severity along with the drinking 5+/4+ at least once a week in the past year criterion. Criteria were invariant across sex, race-ethnicity, and age subgroups. Conclusion-The drinking 5+/4+ high-risk drinking pattern was identified as a suitable criterion for future classifications of DSM-IV alcohol use disorder. Some dependence criteria were among the least severe criteria, and some abuse criteria were among the most severe, findings that question the validity of DSM-IV abuse and dependence categories as distinct entities and that do not support the assumption of abuse as prodromal to dependence. Physical dependence and addiction were identified as defining elements of the continuum. Further research examining their dimensional properties and relationships to high-risk drinking patterns appears warranted. An approach highlighting a more important role of consumption in future classifications of alcohol use disorder defined broadly to encompass all alcohol-related harm, including addiction and physical dependence is discussed.

Section: Dsm-iv Alcohol Abuse and Dependence Criteriamentioning

confidence: 80%

The role of alcohol consumption in future classifications of alcohol use disorders

Saha

Stinson

Grant

2007

200

201

“…Reliability and validity of AUDADIS-IV diagnoses and drug consumption measures-As reported in detail elsewhere (Grant et al, 2003b(Grant et al, , 2004b, reliability and validity were good to excellent for all substance use disorders (Canino et al, 1999;Compton et al, 2004Compton et al, , 2005Grant et al, 1995Grant et al, , 2003aHasin et al, 1997aHasin et al, ,b, 2003Hasin and Paykin, 1999;Vrasti et al, 1998), and fair to good for mood, anxiety, and personality disorders, including ASPD (Canino et al, 1999;Compton et al, 2004Compton et al, , 2005Conway et al, 2005;Grant et al, 2003aGrant et al, , 2004aGrant et al, ,b,c, 2005a. Measures of drug use, including prevalences and ages at onset of use of specific drug classes, displayed fair to excellent reliability (Grant, 1996;Grant and Dawson, 1998;Grant et al, 1995;Hasin et al, 1997a,b).…”

Section: 35mentioning

confidence: 85%

Antisocial behavioral syndromes and DSM-IV drug use disorders in the United States: Results from the National Epidemiologic Survey on Alcohol and Related Conditions

Goldstein

Compton

Pulay

et al. 2007

Background-Antisocial behavioral syndromes, including antisocial personality disorder (ASPD), syndromal adult antisocial behavior (AABS) without conduct disorder (CD) before age 15, and CD without progression to ASPD ("CD only") are highly comorbid with drug use disorders (DUDs). Among patients in DUD treatment, antisocial syndromes are associated with greater severity and poorer outcomes. Comparative data concerning associations of antisocial syndromes with clinical characteristics of DUDs among general population adults have not previously been available. This study describes associations of antisocial syndromes with clinical characteristics of lifetime Diagnostic and Statistical Manual -Version IV DUDs in the general U.S. adult population. Methods-This report is based on the 2001-2002 National Epidemiologic Survey on Alcohol andRelated Conditions (n=43,093, response rate=81%). Respondents (n=4,068) with lifetime DUDs were classified according to whether they met criteria for ASPD, AABS, "CD only," or no antisocial syndrome. Associations of antisocial syndromes with clinical characteristics of DUDs were examined using logistic regression.Results-Antisocial syndromes were significantly associated with the phenomenology of DUDs, particularly ASPD with the most severe clinical presentations. Associations with AABS were similar to those with ASPD; those with "CD only" were weak, inconsistent, and not statistically significant. Patterns of associations differed little between men and women.

“…The reliability of the AUDADIS-IV alcohol diagnoses is documented in clinical and general population samples Grant et al, 2003a;Hasin et al, 1997a) with test retest reliability ranging from good to excellent (κ = 0.70-0.84). Convergent, discriminant, and construct validity of AUDADIS-IV alcohol use disorder criteria and diagnoses were good to excellent (Hasin and Paykin, 1999;Hasin et al, 1990Hasin et al, , 1994Hasin et al, , 2003Hasin et al, , 1997c, including in the World Health Organization/National Institutes of Health International Study on Reliability and Validity Hasin et al, 1997b;Nelson et al, 1999;Pull et al, 1997;Ustun et al, 1997;Vrasti et al, 1998), where clinical reappraisals documented good validity of DSM-IV alcohol use disorder diagnoses (κ = 0.60-0.76) (Canino et al, 1999;Cottler et al, 1997;Hasin et al, 1997b;Nelson et al, 1999;Pull et al, 1997;Ustun et al, 1997;Vrasti et al, 1998).…”

Section: Source Of Datamentioning

confidence: 99%

Generalizability of clinical trials for alcohol dependence to community samples

Blanco

Olfson

Okuda

et al. 2008

There is a growing concern that results of tightly controlled clinical trials of individuals with alcohol use disorders may not generalize to broader community samples. To assess the proportion of community-dwelling adults with alcohol dependence who would have been eligible for a typical alcohol dependence treatment study, we developed a new, simple method: we applied a standard set of eligibility criteria commonly used in alcohol outcome studies to a large (n = 43,093) representative US adult sample interviewed face-to-face, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). We found that approximately one-half (50.5%) of all individuals with a DSM-IV diagnosis of alcohol dependence (n = 1484) and 79.4% of those who sought treatment (n = 185) were excluded by one or more study criteria. Individual study criteria excluded from 0.9% to 48.2% of the overall sample and 0.8% to 43.7% of the treatment-seeking sample. For the overall sample, the lack of motivation/compliance and financial situation criteria excluded the largest percentage of individuals. In the treatment-seeking subsample, comorbid medical conditions and legal problems excluded the largest proportions of individuals. Our study provides a new method to assess the generalizability of clinical trials, and gives further evidence that typical clinical trials for alcohol dependence likely exclude most adults with the disorder in the community and under care, and support the notion that clinical trials recruit "pure" rather than "typical" patients. Clinical trials should carefully evaluate the effects of the selected eligibility criteria on the generalizability of their results.