An evaluation of the proposed DSM-5 alcohol use disorder criteria using Australian national data
An evaluation of the proposed DSM-5 alcohol use disorder criteria using Australian national data
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DOI：
10.1111/j.1360-0443.2010.03340.x
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发表时间：
2011-05-01
期刊：
影响因子：
6
通讯作者：
Teesson, Maree
中科院分区：
文献类型：
--
作者：
Mewton, Louise;Slade, Tim;Teesson, Maree
目的利用流行病学数据评估DSM-IV酒精使用障碍标准的拟议修订。设计、设置和参与者数据来自1997年澳大利亚全国心理健康和幸福调查。样本包括10641名年龄在18岁及以上的参与者。测量方法：使用修订后的CIDI 2.0版评估酒精使用障碍。对所有在过去12个月内饮酒超过12次的应答者进行了酒精使用障碍评估（n = 7746）。研究结果证实性因素分析（CFA）支持引入单一酒精使用障碍的建议。DSM-5标准是单一潜在疾病的所有指标。根据DSM-5，与根据DSM-IV诊断的患者相比，酒精使用障碍的患病率将增加61.7%。在调查最合适的诊断阈值时，3+阈值最大化了DSM-IV和DSM-5诊断之间的一致性，并产生了与DSM-IV相似的患病率估计值。项目反应理论（IRT）分析支持法律标准的删除，但对渴望标准的结果模棱两可。结论：根据拟议的DSM-IV酒精使用障碍修订版，对普通人群患病率的估计将大幅增加。虽然有证据支持一些修订，如单一潜在疾病，但其他修订，如诊断酒精使用障碍的2+阈值和纳入“渴望”标准可能存在问题。
AimsTo evaluate the proposed revisions to the DSM-IV alcohol use disorder criteria using epidemiological data.Design, setting and participantsData came from the 1997 Australian National Survey of Mental Health and Well-Being. The sample consisted of 10 641 participants aged 18 years and over.MeasurementsAlcohol use disorders were assessed using a revised version of the CIDI version 2.0. Alcohol use disorders were assessed in all respondents who indicated that they had used alcohol more than 12 times in the previous 12 months (n = 7746).FindingsThe proposed introduction of a single alcohol use disorder was supported by confirmatory factor analysis (CFA). DSM-5 criteria were all indicators of a single underlying disorder. Under DSM-5, the prevalence of alcohol use disorders would increase by 61.7% when compared with those diagnosed under DSM-IV. When investigating the most appropriate diagnostic threshold, the 3+ threshold maximized agreement between DSM-IV and DSM-5 diagnoses, and produced similar prevalence estimates to those yielded by DSM-IV. Item response theory (IRT) analyses supported the removal of the legal criterion while provided equivocal results for the craving criterion.ConclusionsUnder the proposed DSM-IV revisions for alcohol use disorders, estimates of the prevalence in the general population would increase substantially. Whereas evidence supports some of the revisions such as a single underlying disorder, others such as the 2+ threshold for diagnosis of alcohol use disorder and the inclusion of a 'craving' criterion may be problematic.