Comparison of DSM-IV and DSM-5 criteria for alcohol use disorders in VA primary care patients with frequent heavy drinking enrolled in a trial.
paper
Cited
Public
- Authors
- Takahashi, Traci; Lapham, Gwen; Chavez, Laura J; Lee, Amy K; Williams, Emily C; Richards, Julie E; Greenberg, Diane; Rubinsky, Anna; Berger, Douglas; Hawkins, Eric J; Merrill, Joseph O; Bradley, Katharine A
- Year
- 2017
- Journal
- Addiction science & clinical practice
- PMID
- 28716049
- DOI
- 10.1186/s13722-017-0082-0
- PMCID
- PMC5514480
BACKGROUND: Criteria for alcohol use disorders (AUD) in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) were intended to result in a similar prevalence of AUD as DSM-IV. We evaluated the prevalence of AUD using DSM-5 and DSM-IV criteria, and compared characteristics of patients who met criteria for: neither DSM-5 nor DSM-IV AUD, DSM-5 alone, DSM-IV alone, or both, among Veterans Administration (VA) outpatients in the Considering Healthier drinking Options In primary CarE (CHOICE) trial. METHODS: VA primary care patients who reported frequent heavy drinking and enrolled in the CHOICE trial were interviewed at baseline using the DSM-IV Mini International Neuropsychiatric Interview for AUD, as well as questions about socio-demographics, mental health, alcohol craving, and substance use. We compared characteristics across 4 mutually exclusive groups based on DSM-5 and DSM-IV criteria. RESULTS: Of 304 participants, 13.8% met criteria for neither DSM-5 nor DSM-IV AUD; 12.8% met criteria for DSM-5 alone, and 73.0% met criteria for both DSM-IV and DSM-5. Only 1 patient (0.3%) met criteria for DSM-IV AUD alone. Patients meeting both DSM-5 and DSM-IV criteria had more negative drinking consequences, mental health symptoms and self-reported readiness to change compared with those meeting DSM-5 criteria alone or neither DSM-5 nor DSM-IV criteria. CONCLUSIONS: In this sample of primary care patients with frequent heavy drinking, DSM-5 identified 13% more patients with AUD than DSM-IV. This group had a lower mental health symptom burden and less self-reported readiness to change compared to those meeting criteria for both DSM-IV and DSM-5 AUD. Trial Registration ClinicalTrials.gov NCT01400581. 2011 February 17.
DSM-IV and DSM-5 alcohol use disorder criteria (AUD)
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| Name | Type |
|---|---|
| 10 criteria for DSM-5 AUD local | phenotype |
| 12 step meetings local | drug |
| 4 groups local | cohort |
| Adverse alcohol-related consequences local | phenotype |
| Age >=65 local | phenotype |
| alcohol | phenotype |
| alcohol abuse | phenotype |
| alcohol dependence | phenotype |
| Alcoholics Anonymous | drug |
| Alcohol medications local | drug |
| Alcohol-related negative consequences (past 3 months) local | phenotype |
| Alcohol-related symptom burden local | phenotype |
| alcohol treatment local | drug |
| alcohol treatment history local | phenotype |
| Alcohol Use Disorder | phenotype |
| anxiety | phenotype |
| Asian | cohort |
| AUD | phenotype |
| binge drinking | phenotype |
| Black | phenotype |
| both DSM-IV and DSM-5 AUD local | phenotype |
| Both DSM-IV and DSM-5 AUD local | cohort |
| Both DSM-IV & DSM-5 AUD local | cohort |
| care management trial local | cohort |
| CHOICE intervention local | cohort |
| CHOICE study local | cohort |
| CHOICE trial local | cohort |
| clinical sample of heavy drinkers local | cohort |
| College or post graduate local | phenotype |
| confidence | phenotype |
| Confidence in ability to change local | phenotype |
| craving | phenotype |
| Craving (lifetime) local | phenotype |
| depression | phenotype |
| depressive symptoms | phenotype |
| diagnostic groups local | cohort |
| diagnostic orphans | phenotype |
| drug | drug |
| drug dependence | phenotype |
| drug use comorbidity local | phenotype |
| drug use conditions local | phenotype |
| drug use symptoms local | phenotype |
| DSM-5 alone local | cohort |
| DSM-5 AUD | phenotype |
| DSM-5 AUD alone local | cohort |
| DSM-5 AUD criteria local | phenotype |
| DSM-IV | phenotype |
| DSM-IV alcohol use disorder | phenotype |
| DSM-IV AUD alone local | cohort |
| DSM-IV drug use disorders past year local | phenotype |
| DSM-IV panic disorder—current local | phenotype |
| emergency department patients local | cohort |
| GAD-7 local | phenotype |
| generalized anxiety disorder | phenotype |
| Group Health Institutional Review Boards local | cohort |
| High income | phenotype |
| high-risk Swiss young men local | cohort |
| High school/GED or less local | phenotype |
| Hispanic | phenotype |
| Importance of change local | phenotype |
| Income <$15,000 local | phenotype |
| Income $15,000–59,999 local | phenotype |
| Income ≥$60,000 local | phenotype |
| Income Refused/unknown local | phenotype |
| lifetime craving local | phenotype |
| Lifetime negative consequences due to drinking local | phenotype |
| marital status | phenotype |
| men | cohort |
| mental health comorbidity local | phenotype |
| Mental health co-morbidity local | phenotype |
| Mental health comorbidity local | phenotype |
| mental health or drug use conditions local | phenotype |
| mental health symptoms | phenotype |
| MINI local | phenotype |
| mood disorders | phenotype |
| Multiracial local | phenotype |
| National Epidemiologic Survey on Alcohol and Related Conditions | cohort |
| Native Americans | cohort |
| Native Hawaiian/Pacific Islander local | phenotype |
| negative alcohol-related consequences local | phenotype |
| Negative alcohol-related consequences local | phenotype |
| negative consequences due to drinking local | phenotype |
| Negative consequences due to drinking local | phenotype |
| neither DSM-IV nor DSM-5 AUD local | phenotype |
| Neither DSM-IV nor DSM-5 AUD local | cohort |
| Never sought help due to drinking local | phenotype |
| No Alcohol Use Disorder local | phenotype |
| non-clinical settings local | cohort |
| Opportunistic brief interventions local | drug |
| Other | phenotype |
| other substances | phenotype |
| panic disorder | phenotype |
| parental divorce/separation | phenotype |
| patients | cohort |
| Patients meeting criteria for DSM-5 AUD alone local | cohort |
| Patients meeting criteria for DSM-IV AUD alone local | cohort |
| Patients meeting criteria for Neither DSM-IV nor DSM-5 AUD local | cohort |
| PHQ-9 local | phenotype |
| Post-Traumatic Stress Disorder | phenotype |
| primary care patients local | cohort |
| Primary care patients local | cohort |
| primary care population local | cohort |
| Primary care population local | cohort |
| Prior treatment utilization local | phenotype |
| PTSD Checklist local | phenotype |
| Racial minorities local | cohort |
| Readiness rulers local | phenotype |
| readiness to change | phenotype |
| Refused/unknown (marital) local | phenotype |
| Separated | phenotype |
| Short Inventory of Problems local | phenotype |
| smoking | phenotype |
| social information processing | phenotype |
| Some college/tech school local | phenotype |
| substance use | phenotype |
| tobacco use | phenotype |
| VA | cohort |
| VA primary care clinics local | cohort |
| VA primary care patients local | cohort |
| VA Puget Sound local | cohort |
| VA Puget Sound facilities local | cohort |
| veterans | cohort |
| Veterans Affairs clinics local | cohort |
| White | phenotype |
| White race | phenotype |
| widowed | phenotype |
| women | cohort |
| World Health Organization’s World Mental Health Survey Initiative local | cohort |
| young adults | cohort |
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