Latent Class Analysis of DSM-5 Criteria for Opioid Use Disorders: Results from the Iranian National Survey on Mental Health

Abstract

Background: Assessments of DSM-IV and DSM-5 criteria with sample populations of opioid users are limited. This study aimed to determine the number of latent classes in opioid users and assessment of the proposed revisions to the DSM-5 opioid use disorder (OUD) criteria. Methods: Data came from the 2011 Iranian National Mental Health Survey (IranMHS) on 7,886 participants aged 15-64 years living in Iran. We used the Composite International Diagnostic Interview (CIDI) version 2.1 in all respondents who indicated using opioids at least 5 times in the previous 12 months (n = 236). Results: A three-class model provided the best fit of all the models tested. Classes showed a spectrum of severity that was compatible with the DSM-5 classification. ‘Legal problems' and ‘desire to cut down' showed poor discrimination between classes. The weighted prevalence of OUD using DSM-5 was 20.7% higher than with DSM-IV. Conclusions: Results support the grouping based on severity of symptoms, combining abuse and dependence into a single diagnosis, omitting legal problems, and addition of craving as a new criterion.

Methods for calculation of per capita alcohol consumption in a Muslim majority country with a very low drinking level: Findings from the 2011 Iranian mental health survey

“…It is in line with the observation that a large proportion of those with alcohol use in Iran, answer positively when asked about their motivation and experience in cutting down their use . It is similar to what has been reported for other illicit drugs in Iran . It seems that in the Iranian context, substance (including alcohol) users prefer to underestimate their current or recent use and, instead, indicate they are unwilling to continue substance use.…”

Epidemiology of illicit drug use disorders in Iran: prevalence, correlates, comorbidity and service utilization results from the Iranian Mental Health Survey

“…abuse) than those with dependence. The weighted prevalence of drug use disorder is slightly higher when DSM‐5 criteria are used, due mainly to DSM‐5's lower threshold of two criteria compared to DSM‐IV's three criteria .…”

Exploring the latent trait of opioid use disorder criteria among frequent nonmedical prescription opioid users

“…Our study did not include the Legal Problems criterion because of its exclusion in DSM-5 (American Psychiatric Association, 2013), gives support to a unidimensional model for OUD, despite not including the Craving criterion. An important future direction is to assess LCA in data sources with complete DSM-5 criteria as it was carried out for the entire class of opioids (Tarrahi et al, 2015). …”