Dissociative Identity Disorder: Diagnostic Accuracy and DSM-5 Criteria Change Implications

Background: Many concerns have been raised regarding the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) criteria for Internet gaming disorder and International Classification of Diseases, 11th Revision (ICD-11) criteria for gaming disorder. Aims: In this study, we demonstrated the diagnostic validity of each criterion for Internet gaming disorder in the DSM-5 in terms of their intensity and frequency thresholds and evaluated functional impairments, unhealthy behaviors and complications among adults with Internet gaming disorder and gaming disorder. Methods: We recruited 69 subjects with Internet gaming disorder, 69 regular gamers and 69 controls without regular gaming based on diagnostic interviewing conducted by a psychiatrist according to the DSM-5 Internet gaming disorder criteria. Results: Except for the ‘deceiving’ and ‘escapism’ criteria, all criteria for Internet gaming disorder had a diagnostic accuracy ranging from 84.7% to 93.5% in differentiating between adults with Internet gaming disorder and regular gamers. A total of 44 participants with Internet gaming disorder (63.8%) fulfilled the gaming disorder criteria. In addition, 89% and 100% of the Internet gaming disorder and gaming disorder groups, respectively, had academic, occupational or social functional impairment. Both the Internet gaming disorder and gaming disorder groups had higher rates of delayed sleep phase syndrome and insomnia. The gaming disorder group also had a higher obesity proportion. Conclusion: The ‘deceiving’ and ‘escapism’ criteria had relatively lower diagnostic accuracy. Both the Internet gaming disorder and gaming disorder groups demonstrated functional impairments and unhealthy behaviors. They also exhibited complications, such as obesity and sleep disorders. These results support the utility of the DSM-5 Internet gaming disorder and ICD-11 gaming disorder criteria in identifying individuals who need treatment for both gaming addiction symptoms and complications resulting from the addiction.

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The tail wagging the dog: the diagnostic accuracy of first rank symptoms

BJPsych Advances ◽

10.1192/bja.2019.51 ◽

2019 ◽

Vol 25 (6) ◽

pp. 337-341

Author(s):

Leigh Townsend ◽

Riccardo De Giorgi

Keyword(s):

Diagnostic Accuracy ◽

Early Identification ◽

Cochrane Review ◽

Specific Treatment ◽

High Demand ◽

Antipsychotic Therapy ◽

Dsm 5 ◽

Resource Poor ◽

First Rank Symptoms

SUMMARYOutcomes for people with schizophrenia are improved by expedient diagnosis and specific treatment. ICD-11 and DSM-5 have reduced the importance of Schneider's first rank symptoms (FRS) in the diagnosis of schizophrenia; however, FRS may still offer a useful triage tool for the early identification of schizophrenia and initiation of antipsychotic therapy in high-demand and resource-poor settings. This commentary considers a Cochrane review that assesses the diagnostic accuracy of one or multiple FRS in diagnosing schizophrenia in adults and adolescents.

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Clinical utility of the DSM-5 alternative model for borderline personality disorder: Differential diagnostic accuracy of the BFI, SCID-II-PQ, and PID-5

Comprehensive Psychiatry ◽

10.1016/j.comppsych.2017.09.003 ◽

2018 ◽

Vol 80 ◽

pp. 97-103 ◽

Cited By ~ 11

Author(s):

J. Christopher Fowler ◽

Alok Madan ◽

Jon G. Allen ◽

Michelle Patriquin ◽

Carla Sharp ◽

...

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Diagnostic Accuracy ◽

Alternative Model ◽

Clinical Utility ◽

Borderline Personality ◽

Dsm 5

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Screening Mild and Major Neurocognitive Disorders in Parkinson’s Disease

Behavioural Neurology ◽

10.1155/2015/983606 ◽

2015 ◽

Vol 2015 ◽

pp. 1-10 ◽

Cited By ~ 31

Author(s):

Tivadar Lucza ◽

Kázmér Karádi ◽

János Kállai ◽

Rita Weintraut ◽

József Janszky ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Diagnostic Accuracy ◽

Rating Scale ◽

Cognitive Disorder ◽

Screening Tests ◽

Diagnostic And Statistical Manual ◽

Dsm 5 ◽

Mattis Dementia Rating Scale ◽

State Examination

Introduction. Among the nonmotor features of Parkinson’s disease (PD), cognitive impairment is one of the most troublesome problems. New diagnostic criteria for mild and major neurocognitive disorder (NCD) in PD were established by Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5). The aim of our study was to establish the diagnostic accuracy of widely used screening tests for NCD in PD.Methods. Within the scope of our study we evaluated the sensitivity and specificity of different neuropsychological tests (Addenbrooke’s Cognitive Examination (ACE), Mattis Dementia Rating Scale (MDRS), Mini Mental State Examination (MMSE), and Montreal Cognitive Assessment (MoCA)) in 370 PD patients without depression.Results. MoCA and ACE feature the finest diagnostic accuracy for detecting mild cognitive disorder in PD (DSM-5) at the cut-off scores of 23.5 and 83.5 points, respectively. The diagnostic accuracy of these tests was 0.859 (95% CI: 0.818–0.894, MoCA) and 0.820 (95% CI: 0.774–0.859, ACE). In the detection of major NCD (DSM-5), MoCA and MDRS tests exhibited the best diagnostic accuracy at the cut-off scores of 20.5 and 132.5 points, respectively. The diagnostic accuracy of these tests was 0.863 (95% CI: 0.823–0.897, MoCA) and 0.830 (95% CI: 0.785–0.869, MDRS).Conclusion. Our study demonstrated that the MoCA may be the most suitable test for detecting mild and major NCD in PD.

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

Frontiers in Psychology ◽

10.3389/fpsyg.2021.678819 ◽

2021 ◽

Vol 12 ◽

Author(s):

Lukas A. Basedow ◽

Sören Kuitunen-Paul ◽

Anna Eichler ◽

Veit Roessner ◽

Yulia Golub

Keyword(s):

Drug Use ◽

Diagnostic Accuracy ◽

Factor Model ◽

Short Form ◽

Psychiatric Patients ◽

Area Under The Curve ◽

Roc Curves ◽

Screening Instrument ◽

Dsm 5 ◽

Identification Test

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.

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Evaluation of the Applicability and Usefulness of the Latin American Guide for Psychiatric Diagnosis, Revised Version, in Comparison with other International Systems among Latin American Psychiatrists

The International Journal of Person Centered Medicine ◽

10.5750/ijpcm.v7i4.671 ◽

2019 ◽

Vol 7 (4) ◽

Author(s):

Javier Esteban Saavedra

Keyword(s):

Diagnostic Accuracy ◽

Latin American ◽

Psychiatric Diagnosis ◽

Diagnostic System ◽

Clinical Situation ◽

Classification Systems ◽

Evaluation Instrument ◽

Dsm 5 ◽

The World ◽

Icd 10

Background: The Latin American Guide to Psychiatric Diagnosis, Revised Version (GLADP-VR) represents an adaptation of the ICD-10 that seeks through a biopsychosocial approach to better reflect the holistic framework and culture of Latin American countries. This revision of the original GLADP included updated Latin American annotations and a new integrated diagnostic model centered on the person. Objectives: The aim of this study was to evaluate among Latin American psychiatrists the levels of applicability and usefulness of the GLADP-VR in comparison with major international diagnostic classification systems. Method: The survey evaluation instrument included questions about fundamental characteristics of a useful diagnostic guide and comparative questions about the acceptability and usefulness of the GLADP-VR, the original ICD-10, DSM-IV and DSM-5, and suggestions to improve the guide. The sample included 127 Latin American psychiatrists with an interest on Diagnosis and Classification and membership in one of the 17 national psychiatric societies affiliated with Latin American Psychiatric Association (APAL). They were sent the evaluation instrument by e-mail. Thirty-seven (29.1%) responses were obtained. There were no indications of demographic bias among respondents and no-respondents.The vast majority of respondents answered the questionnaire completely. Ninety-two percent reported knowing the GLADP-VR before the survey and 65.6% had actually used it before.Results: The most commonly used diagnostic system was the original ICD-10 (86.5%), followed by the GLADP-VR (56.8%). Regarding applicability, the diagnostic system recognized as the most user-friendly was the ICD-10 followed by the GLADP-VR, with the most difficult being the DSM-5. Concerning diagnostic accuracy, the GLADP-VR was found most useful; and the DSM-5 was least useful. Regarding usefulness for clinical care and professional practice, the ICD-10 was rated highest, followed by the GLADP-VR, and lowest was DSM-5. The least valued in this regard was the DSM-5. Regarding usefulness for yielding a complete view of the clinical situation, the GLADP-VR was best (83.3%), and DSM-5 was the lowest. Concerning cultural and psychosocial contextualization, the GLADP-VR was considered most useful, well above ICD-10 and the DSMs. Furthermore, the GLADP-VR was considered more useful for teaching and research by about 80% of psychiatrists, superior to the other diagnostic systems.Discussion: The findings of this study on the most prevalent use of ICD-10 are consistent with the results of a survey conducted earlier by the World Psychiatric Association across the world. In addition, in the present study less than half of the respondents used regularly the DSMs. The findings of the present study concerning the GLADP-VR were quite consistent with the corresponding findings of an earlier preliminary evaluation of the GLADP-VR. This seems to be related to the GLADP-VR comprehensive personalized diagnostic formulation with various components, including narratives. Conclusions: There are indications that the GLADP-VR is seen in Latin America as having higher diagnostic accuracy, yielding a comprehensive view of the clinical situation and its context, and more suitable for teaching, research, and work in community mental health.

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Detecting DSM-5 somatic symptom disorder: criterion validity of the Patient Health Questionnaire-15 (PHQ-15) and the Somatic Symptom Scale-8 (SSS-8) in combination with the Somatic Symptom Disorder – B Criteria Scale (SSD-12)

Psychological Medicine ◽

10.1017/s003329171900014x ◽

2019 ◽

Vol 50 (2) ◽

pp. 324-333 ◽

Cited By ~ 5

Author(s):

Anne Toussaint ◽

Paul Hüsing ◽

Sebastian Kohlmann ◽

Bernd Löwe

Keyword(s):

Diagnostic Accuracy ◽

Sensitivity And Specificity ◽

Somatic Symptom ◽

Patient Health Questionnaire ◽

Health Questionnaire ◽

Somatic Symptom Disorder ◽

Symptom Scale ◽

Dsm 5 ◽

Patient Health ◽

Scale 8

BackgroundThe fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) introduced somatic symptom and related disorders (SSD) to improve the diagnosis of somatoform disorders. It is unclear whether existing questionnaires are useful to identify patients with SSD. Our study investigates the diagnostic accuracy of the Patient Health Questionnaire-15 (PHQ-15) and the Somatic Symptom Scale-8 (SSS-8) in combination with the Somatic Symptom Disorder – B Criteria Scale (SSD-12).MethodsFor this cross-sectional study, participants were recruited from a psychosomatic outpatient clinic. PHQ-15, SSS-8, and SSD-12 were administered and compared with SSD criteria from a diagnostic interview. Sensitivity and specificity were calculated for optimal individual and combined cutpoints. Receiver operator curves were created and area under the curve (AUC) analyses assessed.ResultsData of n = 372 patients [31.2% male, mean age: 39.3 years (s.d. = 13.6)] were analyzed. A total of 56.2% fulfilled the SSD criteria. Diagnostic accuracy was moderate for each questionnaire (PHQ-15: AUC = 0.70; 95% CI = 0.65–0.76; SSS-8: AUC = 0.71; 95% CI = 0.66–0.77; SSD-12: AUC = 0.74; 95% CI = 0.69–0.80). Combining questionnaires improved diagnostic accuracy (PHQ-15 + SSD-12: AUC = 0.77; 95% CI = 0.72–0.82; SSS-8 + SSD-12: AUC = 0.79; 95% CI = 0.74–0.84). Optimal combined cutpoints were ⩾9 for the PHQ-15 or SSS-8, and ⩾23 for the SSD-12 (sensitivity and specificity = 69% and 70%).ConclusionsThe combination of the PHQ-15 or SSS-8 with the SSD-12 provides an easy-to-use and time- and cost-efficient opportunity to identify persons at risk for SSD. If systematically applied in routine care, effective screening and subsequent treatment might help to improve quality of life and reduce health care excess costs.

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