A test of the DSM-5 severity scale for alcohol use disorder

作者：Fazzino Tera L^*; Rose Gail L; Burt Keith B; Helzer John E

来源：Drug and Alcohol Dependence, 2014, 141: 39-43.

DOI：10.1016/j.drugalcdep.2014.05.004

• DSM-5
• Diagnosis
• Alcohol use disorder severity
• Dimensional
• Alcohol use disorder
• Multi-model inference

Background: For the DSM-5-defined alcohol use disorder (AUD) diagnosis, a tri-categorized scale that designates mild, moderate, and severe AUD was selected over a fully dimensional scale to represent AUD severity. The purpose of this study was to test whether the DSM-5-defined AUD severity measure was as proficient a predictor of alcohol use following a brief intervention, compared to a fully dimensional scale. %26lt;br%26gt;Methods: Heavy drinking primary care patients (N = 246) received a physician-delivered brief intervention (BI), and then reported daily alcohol consumption for six months using an Interactive Voice Response (IVR) system. The dimensional AUD measure we constructed was a summation of all AUD criteria met at baseline (mean = 6.5; SD = 2.5). A multi-model inference technique was used to determine whether the DSM-5 tri-categorized severity measure or a dimensional approach would provide a more precise prediction of change in weekly alcohol consumption following a BI. %26lt;br%26gt;Results: The Akaike information criterion (AIC) for the dimensional AUD model (AIC= 7623.88) was four points lower than the tri-categorized model (AIC = 7627.88) and weight of evidence calculations indicated there was 88% likelihood the dimensional model was the better approximating model. The dimensional model significantly predicted change in alcohol consumption (p =.04) whereas the DSM-5 tri-categorized model did not. %26lt;br%26gt;Conclusion: A dimensional AUD measure was superior, detecting treatment effects that were not apparent with tri-categorized severity model as defined by the DSM-5. We recommend using a dimensional measure for determining AUD severity.

• 出版日期2014-8-1