The Alcohol Dependence Scale and DSM‐5 alcohol use disorder: Severity ratings correspond insufficiently in older patients

Abstract. Background: The number of older adults with alcohol use disorder (AUD) is expected to rise. Adapted treatments for this group are lacking and information on AUD features in treatment seeking older adults is scarce. The international multicenter randomized-controlled clinical trial “ELDERLY-Study” with few exclusion criteria was conducted to investigate two outpatient AUD-treatments for adults aged 60+ with DSM-5 AUD. Aims: To add to 1) basic methodological information on the ELDERLY-Study by providing information on AUD features in ELDERLY-participants taking into account country and gender, and 2) knowledge on AUD features in older adults seeking outpatient treatment. Methods: baseline data from the German and Danish ELDERLY-sites (n=544) were used. AUD diagnoses were obtained with the Mini International Neuropsychiatric Interview, alcohol use information with Form 90. Results: Lost control, desired control, mental/physical problem, and craving were the most prevalent (> 70 %) AUD-symptoms. 54.9 % reported severe DSM-5 AUD (moderate: 28.2 %, mild: 16.9 %). Mean daily alcohol use was 6.3 drinks at 12 grams ethanol each. 93.9 % reported binging. More intense alcohol use was associated with greater AUD-severity and male gender. Country effects showed for alcohol use and AUD-severity. Conclusion: European ELDERLY-participants presented typical dependence symptoms, a wide range of severity, and intense alcohol use. This may underline the clinical significance of AUD in treatment-seeking seniors.

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Residual alcohol use disorder symptoms after treatment predict long‐term drinking outcomes in seniors with DSM‐5 alcohol use disorder

Alcoholism Clinical and Experimental Research ◽

10.1111/acer.14722 ◽

2021 ◽

Author(s):

Silke Behrendt ◽

Alexis Kuerbis ◽

Barbara Braun‐Michl ◽

Randi Bilberg ◽

Gerhard Bühringer ◽

...

Keyword(s):

Alcohol Use ◽

Alcohol Use Disorder ◽

Dsm 5 ◽

Drinking Outcomes

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The etiology of DSM-5 alcohol use disorder: Evidence of shared and non-shared additive genetic effects

Drug and Alcohol Dependence ◽

10.1016/j.drugalcdep.2018.12.034 ◽

2019 ◽

Vol 201 ◽

pp. 147-154 ◽

Cited By ~ 1

Author(s):

Rohan H.C. Palmer ◽

Leslie A. Brick ◽

Yi-Ling Chou ◽

Arpana Agrawal ◽

John E. McGeary ◽

...

Keyword(s):

Alcohol Use ◽

Alcohol Use Disorder ◽

Genetic Effects ◽

Dsm 5 ◽

Additive Genetic Effects

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Evaluation of childhood traumatic experience as a risk factor for alcohol use disorder in adulthood

BMC Psychiatry ◽

10.1186/s12888-020-2428-5 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Lan Wang ◽

Cui-Xia An ◽

Mei Song ◽

Na Li ◽

Yuan-Yuan Gao ◽

...

Keyword(s):

Risk Factors ◽

Alcohol Use ◽

Alcohol Abuse ◽

Alcohol Dependence ◽

Physical Abuse ◽

Emotional Abuse ◽

Alcohol Use Disorder ◽

Alcohol Use Disorders ◽

Traumatic Experience ◽

Frequent Drinking

Abstract Background We aimed to investigate the effect of early-age (prenatal, infant, and childhood) trauma on adulthood alcohol use disorder. Methods A total number of 1534 subjects who were born and live in the city of Tangshan were selected. The subjects were divided into three age groups. General demographic data, conditions of the mothers during pregnancy, and condition of the babies at birth, were collected. The diagnosis of alcohol use disorder was based on Structured Clinical Interviews for DSM-IV Axis Disorders (patient version) (SCID). The childhood trauma questionnaire short form (CTQ-SF) [1] and the Lifetime of Experience Questionnaire (LTE-Q) [2] were used to evaluate stress in childhood and adulthood, respectively. Results Only male subjects were diagnosed with lifelong alcohol abuse and alcohol dependence. There was no statistically significant difference in the prevalence of lifetime alcohol use disorder (X2 = 4.480, P = 0.345), current alcohol abuse, and current alcohol dependence among the three groups (X2abuse = 2.177, X2depedence = 2.198, P > 0.05). However, higher prevalence of lifetime alcohol use disorders was found in group with higher scores of CTQ (X2 = 9.315, P = 0.009), emotional abuse (X2 = 8.025, P = 0.018), physical abuse (X2 = 20.4080, P < 0.001), but not in the group with higher scores of emotional neglect (X2 = 1.226, P = 0.542), sexual abuse (X2 = 2.779, P = 0.249), physical neglect (X2 = 3.978, P = 0.137), LTE-Q (X2 = 5.415, P = 0.067), and PSQI (X2 = 5.238, P = 0.073). Protective factor for alcohol abuse for men was identified to be heavy drinking (OR = 0.085, 95%CI: 0.011–0.661), and the risk factors for alcohol abuse were identified to be frequent drinking (OR = 2.736, 95%CI: 1.500, 4.988), and consumption of low liquor (OR = 2.563, 95%CI: 1.387, 4.734). Risk factors for alcohol dependence in males were identified to be consumption of low liquor (OR = 5.501, 95%CI: 2.004, 15.103), frequent drinking (OR = 2.680, 95%CI: 1.164, 6.170), and childhood physical abuse (OR = 2.310, 95% CI: 1.026, 5.201). Conclusion Traumatic experience during infant and prenatal periods does not have a strong statistical correlation with alcohol use disorders for male adults. However, subjects with high CTQ scores, experience of emotional abuse and physical abuse show a statistically higher prevalence of lifetime alcohol use disorders. Several risk factors including consumption of low liquor, frequent drinking, and childhood physical abuse contribute to alcohol dependence in male adults.

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A data-driven method for identifying shorter symptom criteria sets: the case for DSM-5 alcohol use disorder

Psychological Medicine ◽

10.1017/s0033291718001551 ◽

2018 ◽

Vol 49 (6) ◽

pp. 931-939 ◽

Cited By ~ 2

Author(s):

Cheryl D. Raffo ◽

Deborah S. Hasin ◽

Paul Appelbaum ◽

Melanie M. Wall

Keyword(s):

Alcohol Use ◽

Alcohol Use Disorder ◽

Short Form ◽

Data Driven ◽

Short Forms ◽

Dsm 5 ◽

Epidemiologic Survey ◽

Sas Macro ◽

Continuous Improvement Model ◽

Sum Scores

AbstractBackgroundAlthough the DSM is a widely used diagnostic guide, lengthy criteria sets can be problematic and provide the primary motivation to identify short-forms. Using the 11 diagnostic criteria provided by the DSM-5 for alcohol use disorder (AUD), the present study develops a data-driven method to systematically identify subsets and associated cut-offs that yield diagnoses as similar as possible to use all 11 criteria.MethodRelying on data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III), our methodology identifies diagnostic short-forms for AUD by: (1) maximizing the association between the sum scores of all 11 criteria with newly constructed subscales from subsets of criteria; (2) optimizing the similarity of AUD prevalence between the current DSM-5 rule and newly constructed diagnostic short-forms; (3) maximizing sensitivity and specificity of the short-forms against the current DSM-5 rule; and (4) minimizing differences in the accuracy of the short-form across chosen covariates. Replication is shown using NESARC-Wave 2.ResultsMore than 11 000 diagnostic short-forms for DSM-5 AUD can be created and our method narrows down the optimal choices to eight. Results found that ‘Neglecting major roles’ and ‘Activities given up’ could be dropped with practically no change in who is diagnosed (specificity = 100%, sensitivity ⩾ 99.6%) or the severity of those diagnosed (κ = 0.97).ConclusionsWith a continuous improvement model adopted by the APA for DSM revisions, we offer a data-driven tool (a SAS Macro) that identifies diagnostic short-forms in a systematic and reproducible way to help advance potential improvements in future DSM revisions.

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