A Comparison of <i>DSM</i>-IV Versus <i>DSM</i>-5 Substance Use Disorder Diagnoses in Adolescent Populations

Malone, Marisa; Hoffmann, Norman G.

doi:10.1080/1067828x.2015.1049679

Cited by 5 publications

(1 citation statement)

References 33 publications

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“…Information on which symptoms were endorsed, however, can be relevant to treatment planning, monitoring treatment progress, and is also important for refining the diagnostic algorithm (Proctor et al., ). Further, prior research indicates that specific criteria tend to indicate lower (e.g., tolerance) and higher (e.g., withdrawal) levels of SUD severity for substances such as alcohol, cannabis, and cocaine (Gelhorn et al., ; Hartman et al., ; Kopak et al., ; Langenbucher et al., ; Malone and Hoffmann, ; Martin et al., ). In this regard, each ICD‐11 dependence criterion represents a cluster of symptoms, of which the symptom with the lowest SUD severity will typically determine whether a dependence criterion is present, because the less severe symptom is generally reported more commonly than the more severe symptom.…”

Section: Discussionmentioning

confidence: 99%

Greater Prevalence of Proposed ICD-11 Alcohol and Cannabis Dependence Compared to ICD-10, DSM-IV, and DSM-5 in Treated Adolescents

Chung

Cornelius

Clark

et al. 2017

Alcohol Clin Exp Res

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Background Proposed International Classification of Diseases, 11th edition (ICD-11) criteria for substance use disorder (SUD) radically simplify the algorithm used to diagnose substance dependence. Major differences in case identification across Diagnostic and Statistical Manual (DSM) and ICD impact determinations of treatment need and conceptualizations of substance dependence. This study compared the draft algorithm for ICD-11 SUD against DSM-IV, DSM-5, and ICD-10, for alcohol and cannabis. Methods Adolescents (n=339, ages 14–18) admitted to intensive outpatient addictions treatment completed, as part of a research study, a Structured Clinical Interview for DSM SUDs (SCID) adapted for use with adolescents, and which has been used to assess DSM and ICD SUD diagnoses. Analyses examined prevalence across classification systems, diagnostic concordance, and sources of diagnostic disagreement. Results Prevalence of any past year proposed ICD-11 alcohol or cannabis use disorder was significantly lower compared to DSM-IV and DSM-5 (ps <.01). However, prevalence of proposed ICD-11 alcohol and cannabis dependence diagnoses was significantly higher compared to DSM-IV, DSM-5 and ICD-10 (ps <.01). ICD-11 and DSM-5 SUD diagnoses showed only moderate concordance. For both alcohol and cannabis, youth typically met criteria for an ICD-11 dependence diagnosis by reporting tolerance and much time spent using or recovering from the substance, rather than symptoms indicating impaired control over use. Conclusions The proposed ICD-11 dependence algorithm appears to “over diagnose” dependence on alcohol and cannabis relative to DSM-IV and ICD-10 dependence, and DSM-5 moderate/severe use disorder, generating potential “false positive” cases of dependence. Among youth who met criteria for proposed ICD-11 dependence, few reported impaired control over substance use, highlighting on-going issues in the conceptualization and diagnosis of SUD.

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