Reliability of DSM-IV diagnostic criteria using the semi-structured assessment for drug dependence and alcoholism (SSADDA)

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• 作者：Amira Pierucci-Lagha ; Joel Gelernter ; Grace Chan ; Albert Arias ; Joseph F. Cubells ; Lindsay Farrer ; Henry R. Kranzler
• 关键词：Diagnostic reliability ; Concordance ; DSM-IV criteria ; Substance dependence ; Chance-corrected agreement ; Reliability analysis
• 刊名：Drug and Alcohol Dependence
• 出版年：2007
• 出版时间：2 November 2007
• 年：2007
• 卷：91
• 期：1
• 页码：85-90
• 全文大小：145 K

文摘

The semi-structured assessment for drug dependence and alcoholism (SSADDA) yields reliable DSM-IV diagnoses for a variety of psychiatric disorders, including alcohol and drug dependence. This study examines the reliability of individual DSM-IV criteria for lifetime substance dependence diagnoses and the impact of those criteria on diagnostic reliability.

Methods

Two hundred ninety-three subjects (52.2 % women; 38.2 % African American, 46.8 % European American, 7.5 % Hispanic) were interviewed twice over a 2-week period to examine the inter-rater reliability (n = 173) or test–retest reliability (n = 120) of the SSADDA. Cohen's κ-statistic and its confidence interval were used to assess the reliability of individual diagnostic criteria.

Results

Overall, the inter-rater reliability estimates were excellent for individual DSM-IV criteria for nicotine and opioid dependence; good for alcohol and cocaine dependence, and fair for dependence on cannabis, sedatives and stimulants. The impact of any individual criterion on diagnostic reliability was minimal, consistent with the notion that the DSM-IV diagnosis of substance dependence measures an underlying construct that is relatively consistent across specific groups of substances.

Conclusions

These results, combined with results from a study of the SSADDA's diagnostic reliability [Pierucci-Lagha, A., Gelernter, J., Feinn, R., Cubells, J.F., Pearson, D., Pollastri, A., Farrer, L., Kranzler, H.R., 2005. Diagnostic reliability of the semi-structured assessment for drug dependence and alcoholism (SSADDA). Drug Alcohol Depend. 80, 303–312], show that the instrument can be used reliably to assess substance dependence.