Diagnostic Accuracy of the Drug Use Disorder Identification Test and Its Short Form, the DUDIT-C, in German Adolescent Psychiatric Patients

Abstract

BackgroundA common screening instrument for substance use disorders (SUDs) is the Drug Use Disorders Identification Test (DUDIT) which includes a short form regarding only drug consumption (DUDIT-C). We aim to assess if a German version of the DUDIT, adapted for adolescents, is a suitable screening instrument in a sample of adolescent psychiatric patients.MethodsN = 124 (54 female) German adolescent (M = 15.6 + 1.5 years) psychiatric patients completed the DUDIT and received a diagnostic interview (MINI-KID) assessing DSM-5 SUD criteria. A confirmatory factor analysis (CFA), receiver operating characteristic (ROC) curves, the area under the curve (AUC), and Youden’s Index were calculated.ResultsA two-factor model of the DUDIT shows the best model fit (CFI = 0.995, SRMR = 0.055, RMSEA = 0.059, WRMR = 0.603). The DUDIT as well as the DUDIT-C show high diagnostic accuracy, with AUC = 0.95 and AUC = 0.88, respectively. For the DUDIT a cut-off value of 8.5 was optimal (sensitivity = 0.93, specificity = 0.91, J = 0.84), while for the DUDIT-C the optimal cut-off value was at 1.5 (sensitivity = 0.86, specificity = 0.84, J = 0.70).ConclusionThis is the first psychometric evaluation of the DUDIT in German, adolescent psychiatric outpatients, using the DSM-5 diagnostic criteria. The DUDIT as well as the DUDIT-C are well suited for use in this population. Since in our sample only few patients presented with a mild or moderate SUD, our results need to be replicated in a sample of adolescents with mild SUD.

Swedish High School Students’ Drug and Alcohol Use Habits throughout 2020

“…While the significant differences were shown at the item level, it is important to recognize that only four of these item differences reached a small effect size; the others were negligible. Those four items were the first four questions, focusing on drug consumption [ 32 ] and measured frequency of drug use (item 1: “How often do you use drugs other than alcohol?”; item 3: “How many times do you take drugs on a typical day when you use drugs?”), the frequency of heavy drug use (item 4: “How often are you influenced heavily by drugs?”), and the existence of polydrug use (item 2: “Do you use more than one type of drug on the same occasion?”). This indicates that Swedish male adolescents use more types of drugs more often and more seriously than females do, while the consequences of drug use (captured by items 5–11) significantly differed between the genders but without a measurable effect size at item level, and with the lowest verge of a small effect size at a factor level.…”

“…However, using the previously validated cutoffs for the DUDIT [ 28 ], the prevalence rates of drug abuse among the Swedish adolescents in our sample are in line with those from national and European surveys [ 6 ], indicating a higher prevalence of females being dependent on substances. Interestingly, in a recently published validation of the DUDIT in a psychiatric adolescent population, only gender-neutral cutoffs were identified for the DUDIT; furthermore, pattern identification was based on its first four items (consumption), for screening use within clinical populations [ 32 ]. Our results therefore strengthen the importance of the first four items (consumption factor) of DUDIT in the identification for substance use disorder among adolescents.…”

“…Factor 1 (items 1–4) refers to consumption, with scores between 0 and 16. Factor 2 (items 5–11) refers to drug-related problems with a possible score ranging between 0 and 28 [ 32 ].…”

Comparing self-report and parental report of psychopathologies in adolescents with substance use disorders

“…Analyses [41] for a dimensionality discussion). Thus the same replacement procedure was applied for the n = 9 adolescents with one missing item and the n = 2 adolescents with two missing items, effectively replacing 15 missing values out of 682 analyzed values (2.1%).…”

“…For the calculation of the "any comorbid diagnosis" variable, cases with missing information were assumed to have no diagnosis in this field, resulting in N = 70 for "any comorbid diagnosis" d No diagnoses from any of the following ICD-10 mental disorder classes were present: F20-F29 Schizophrenia, schizotypal and delusional disorders (n = 64); F50-F59 Behavioral syndromes associated with physiological disturbances and physical factors; F70-F79 Mental retardation e Personality disorders may, in certain cases, be present during late adolescence (i.e. age 16 and older) although a formal diagnosis may require information beyond a structured clinical interview with the patient [1] Patients N (%) [41,42] and suggested a cut-off of 8.5 + to be indicative for SUD in adolescents [41].…”