DSM-5 and ICD-11 alcohol use disorder criteria in young adult regular drinkers: Lifetime prevalence and age of onset

Slade, Tim; Mewton, Louise; O’Dean, Siobhan; Tibbetts, Joel; Clay, Peter; Isik, Ashling; Johnson, Phoebe; McCraw, Stacey; Upton, Emily; Kypri, Kypros; Butterworth, Peter; McBride, Nyanda; Swift, Wendy

doi:10.1016/j.drugalcdep.2021.109184

Cited by 16 publications

(19 citation statements)

References 47 publications

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“…The sample size for some of the tolerance definitions are small, limiting the robustness of some regressions. However, tolerance is generally endorsed at a much higher rate than most other AUD criteria [23]. Indeed, an AUD criterion that is endorsed by upward of 40% of a non‐clinical sample is not likely to be a sensitive or specific assessment of AUD.…”

Section: Discussionmentioning

confidence: 99%

“…Participants were subsequently invited to complete four follow-up telephone SCID-IV-RV interviews conducted at 6-month intervals each assessing alcohol consumption and AUD criteria, including tolerance, for the preceding 6-month period. Further information on the SCID-IV-RV and its reliability in our sample can be found in [23]. The primary research question and analyses were not pre-registered.…”

Section: Methodsmentioning

confidence: 99%

“…The RADAR study used a modified version of the SCID‐IV‐RV to assess symptoms of DSM‐5 AUD criteria [27]. Each AUD criterion was assessed for clinical significance; specifically, whether a symptom occurred with the requisite severity and frequency (for further details see [23]). When assessing the predictive power of different tolerance definitions against longitudinal AUD diagnoses, tolerance was excluded from the overall AUD diagnosis.…”

Section: Methodsmentioning

confidence: 99%

“…The RADAR cohort had good retention, with 80.4% of participants remaining in the study at the final follow‐up and 376 participants completing all four follow‐up interviews (see [23] and Supporting information, Fig. S1).…”

Section: Methodsmentioning

confidence: 99%

“…The sample was derived from the RADAR study [22,23]. RADAR participants were recruited in 2016-18 from an existing, and ongoing, cohort of 1603 adolescents participating in the Australian Parental Supply for Alcohol Longitudinal Study (APSALS) [24][25][26].…”

Section: Study Samplementioning

confidence: 99%

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Definition matters: assessment of tolerance to the effects of alcohol in a prospective cohort study of emerging adults

et al. 2022

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Background and aims: Tolerance to the effects of alcohol is an important element in the diagnosis of alcohol use disorders (AUD); however, there is ongoing debate about its utility in the diagnosis AUD in adolescents and young adults. This study aimed to refine the assessment of tolerance in young adults by testing different definitions of tolerance and their associations with longitudinal AUD outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Study Samplementioning

confidence: 99%

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Definition matters: assessment of tolerance to the effects of alcohol in a prospective cohort study of emerging adults

et al. 2022

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Diagnostic Criteria for Identifying Individuals at High Risk of Progression From Mild or Moderate to Severe Alcohol Use Disorder

Miller,

Kuo,

Johnson

et al. 2023

JAMA Netw Open

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ImportanceCurrent Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5) diagnoses of substance use disorders rely on criterion count–based approaches, disregarding severity grading indexed by individual criteria.ObjectiveTo examine correlates of alcohol use disorder (AUD) across count-based severity groups (ie, mild, moderate, mild-to-moderate, severe), identify specific diagnostic criteria indicative of greater severity, and evaluate whether specific criteria within mild-to-moderate AUD differentiate across relevant correlates and manifest in greater hazards of severe AUD development.Design, Setting, and ParticipantsThis cohort study involved 2 cohorts from the family-based Collaborative Study on the Genetics of Alcoholism (COGA) with 7 sites across the United States: cross-sectional (assessed 1991-2005) and longitudinal (assessed 2004-2019). Statistical analyses were conducted from December 2022 to June 2023.Main Outcomes and MeasuresSociodemographic, alcohol-related, psychiatric comorbidity, brain electroencephalography (EEG), and AUD polygenic score measures as correlates of DSM-5 AUD levels (ie, mild, moderate, severe) and criterion severity–defined mild-to-moderate AUD diagnostic groups (ie, low-risk vs high-risk mild-to-moderate).ResultsA total of 13 110 individuals from the cross-sectional COGA cohort (mean [SD] age, 37.8 [14.2] years) and 2818 individuals from the longitudinal COGA cohort (mean baseline [SD] age, 16.1 [3.2] years) were included. Associations with alcohol-related, psychiatric, EEG, and AUD polygenic score measures reinforced the role of increasing criterion counts as indexing severity. Yet within mild-to-moderate AUD (2-5 criteria), the presence of specific high-risk criteria (eg, withdrawal) identified a group reporting heavier drinking and greater psychiatric comorbidity even after accounting for criterion count differences. In longitudinal analyses, prior mild-to-moderate AUD characterized by endorsement of at least 1 high-risk criterion was associated with more accelerated progression to severe AUD (adjusted hazard ratio [aHR], 11.62; 95% CI, 7.54-17.92) compared with prior mild-to-moderate AUD without endorsement of high-risk criteria (aHR, 5.64; 95% CI, 3.28-9.70), independent of criterion count.Conclusions and RelevanceIn this cohort study of a combined 15 928 individuals, findings suggested that simple count-based AUD diagnostic approaches to estimating severe AUD vulnerability, which ignore heterogeneity among criteria, may be improved by emphasizing specific high-risk criteria. Such emphasis may allow better focus on individuals at the greatest risk and improve understanding of the development of AUD.

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Disorders Due to Substance Use: General Approaches

Kosten,

Domingo

2023

Tasman’s Psychiatry

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DSM-5 and ICD-11 alcohol use disorder criteria in young adult regular drinkers: Lifetime prevalence and age of onset

Cited by 16 publications

References 47 publications

Definition matters: assessment of tolerance to the effects of alcohol in a prospective cohort study of emerging adults

Definition matters: assessment of tolerance to the effects of alcohol in a prospective cohort study of emerging adults

Diagnostic Criteria for Identifying Individuals at High Risk of Progression From Mild or Moderate to Severe Alcohol Use Disorder

Disorders Due to Substance Use: General Approaches

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