Although the concordance rates were high for all four substances, some patterns are discernible when examining the conditional odds ratios for the discordant cases, which describe the relative rates of the two possible types of discordance. For example, the conditional odds ratio for alcohol (see Table 2) indicates that, among discordant subjects, the odds of switching from no diagnosis under DSM-IV to a diagnosis under DSM-5 are 1.26 times the odds of switching in the opposite direction. For all four substances, the odds ratios exceed 1 and, with the exception of opioids, the corresponding 95% confidence intervals exclude 1. Thus, with the exception of opioids, among discordant subjects, switching from no diagnosis under DSM-IV to a diagnosis under DSM-5 is significantly more likely than a switch in the opposite direction. This means that the application of DSM-5 criteria should lead to a higher prevalence of SUD diagnoses than with DSM-IV criteria, although the differences will be small.
