The Use of the Severity Dependence Scale (SDS) as an Outcome in Studies of Alcohol and Other Drug Use a Systematic Review

Abstract

Introduction: The Severity Dependence Scale (SDS) is a validated measure of the severity of dependence on alcohol or drugs. SDS scores can be used to guide treatment planning, monitor progress, and evaluate treatment outcomes. Objectives: We aimed to review studies that analysed SDS as an outcome in studies of alcohol and drug use (AoD), with a particular focus on the methodology used to examine the changes in SDS. Methods: The search was performed using the literature databases Embase, PubMed and Medline. Articles were included when the outcome was SDS in AoD. Studies that examined SDS, but not among the AoD population, studies that reported SDS as predictors, qualitative research, study protocols, conference papers, and studies in non-English language were excluded. Results: Among 179 articles identified, 15 were included in the systematic review. Two studies conducted cannabis research, two for methamphetamine, one for cannabis and amphetamine, one for cocaine, one for ketamine, one for ecstasy and seven for general illicit drugs. Out of 15 studies, ten used the t-test for statistical analysis of the SDS, one used a generalised estimating equation, one used a Spearman non-parametric test, and one used a linear mixed model, one reported the baseline score for the SDS and did not report the SDS at follow-up, one reported a descriptive analysis of the SDS. Conclusions: In the absence of a standardised cut-off score and a minimal important difference, more attention should be paid in analysing the discrete scale of the SDS to ensure analysis accuracy.