Home > A cross-national examination of differences in classification of lifetime alcohol use disorder between DSM-IV and DSM-5: findings from the World Mental Health Survey.

Slade, Tim and Chiu, Wai-Tat and Glantz, Meyer and Kessler, Ronald C and Lago, Luise and Sampson, Nancy and Al-Hamzawi, Ali and Florescu, Silvia and Moskalewicz, Jacek and Murphy, Sam and Navarro-Mateu, Fernando and Torres de Galvis, Yolanda and Viana, Maria Carmen and Xavier, Miguel and Degenhardt, Louisa . (2016) A cross-national examination of differences in classification of lifetime alcohol use disorder between DSM-IV and DSM-5: findings from the World Mental Health Survey. Alcoholism, Clinical and Experimental Research, 40 (8)

URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC51296...

BACKGROUND: The current study sought to examine the diagnostic overlap in DSM-IV and DSM-5 alcohol use disorder (AUD) and determine the clinical correlates of changing diagnostic status across the 2 classification systems.

METHODS: DSM-IV and DSM-5 definitions of AUD were compared using cross-national community survey data in 9 low-, middle-, and high-income countries. Participants were 31,367 respondents to surveys in the World Health Organization's World Mental Health Survey Initiative. The Composite International Diagnostic Interview, version 3.0, was used to derive DSM-IV and DSM-5 lifetime diagnoses of AUD. Clinical characteristics, also assessed in the surveys, included lifetime DSM-IV anxiety; mood and drug use disorders; lifetime suicidal ideation, plan, and attempt; general functional impairment; and psychological distress.

RESULTS: Compared with DSM-IV AUD (12.3%, SE = 0.3%), the DSM-5 definition yielded slightly lower prevalence estimates (10.8%, SE = 0.2%). Almost one-third (n = 802) of all DSM-IV abuse cases switched to subthreshold according to DSM-5 and one-quarter (n = 467) of all DSM-IV diagnostic orphans switched to mild AUD according to DSM-5. New cases of DSM-5 AUD were largely similar to those who maintained their AUD across both classifications. Similarly, new DSM-5 noncases were similar to those who were subthreshold across both classifications. The exception to this was with regard to the prevalence of any lifetime drug use disorder.

CONCLUSIONS: In this large cross-national community sample, the prevalence of DSM-5 lifetime AUD was only slightly lower than the prevalence of DSM-IV lifetime AUD. Nonetheless, there was considerable diagnostic switching, with a large number of people inconsistently identified across the 2 DSM classifications.


Item Type:Evidence resource
Drug Type:Alcohol
Intervention Type:AOD disorder
Date:August 2016
Page Range:pp. 1728-36
Volume:40
Number:8
EndNote:View
Subjects:B Drugs and alcohol substances > Alcohol
G Health and disease > State of health > Mental health
G Health and disease > Disorder classification
G Health and disease > Drugs and alcohol disorder > Alcohol use
G Health and disease > Drugs and alcohol disorder > Alcohol use > Alcohol dependence
G Health and disease > Drugs and alcohol related disorder > Drugs and alcohol related mental disorder

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