Comparative performance of the AUDIT-C in screening for DSM-IV and DSM-5 alcohol use disorders

作者：Dawson Deborah A^*; Smith Sharon M; Saha Tulshi D; Rubinsky Anna D; Grant Bridget F

来源：Drug and Alcohol Dependence, 2012, 126(3): 384-388.

DOI：10.1016/j.drugalcdep.2012.05.029

• AUDIT-C
• Screening
• Alcohol use disorder
• DSM-IV
• DSM-5

Objective: Under the proposed DSM-5 revision to the criteria for alcohol use disorder (AUD), a substantial proportion of DSM-IV AUD cases will be lost or shifted in terms of severity, with some new cases added. 'Accordingly, the performance of the AUDIT-C in screening for DSM-IV AUD cannot be assumed to extend to DSM-5 AUD. The objective of this paper is to compare the AUDIT-C in screening for DSM-IV and DSM-5 AUD.
Methods: Using a broad range of performance metrics, the AUDIT-C was tested and contrasted as a screener for DSM-IV AUD (any AUD, abuse and dependence) and DSM-5 AUD (any AUD, moderate AUD and severe AUD) in a representative sample of U.S. adults aged 21 and older and among past-year drinkers.
Results: Optimal AUDIT-C cutpoints were identical for DSM-IV and DSM-5 AUD: >= 4 for any AUD, >= 3 or >= 4 for abuse/moderate AUD and >= 4 or >= 5 for dependence/severe AUD. Screening performance was slightly better for DSM-5 severe AUD than DSM-IV dependence but did not differ for other diagnoses. At optimal screening cutpoints, positive predictive values were slightly higher for DSM-5 overall AUD and moderate AUD than for their DSM-IV counterparts. Sensitivities were slightly higher for DSM-5 severe AUD than DSM-IV dependence. Optimal screening cutpoints shifted upwards for past-year drinkers but continued to be identical for DSM-IV and DSM-5 disorders.
Conclusions: Clinicians should not face any major overhaul of their current screening procedures as a result of the DSM-5 revision and should benefit from fewer false positive screening results. Published by Elsevier Ireland Ltd.

• 出版日期2012-12-1