AbstractAimIn DSM-5, definitions of substance use disorders (SUD) were changed considerably from DSM-IV, yet little is known about how well DSM-IV and DSM-5 SUD diagnoses agree with each other within a series of individuals with substance use problems.MethodsPrevalences and chance-corrected agreement of DSM-5 SUD and DSM-IV substance dependence were evaluated in 588 adult substance users, interviewed by clinician interviewers using the semi-structured Psychiatric Research Interview for Substance and Mental Disorders (PRISM-5). Alcohol, tobacco, cannabis, cocaine, heroin, opioid, sedative, and stimulant use disorders were examined. Cohen’s kappa was used to assess agreement between DSM-5 and DSM-IV SUD (including abuse or dependence), DSM-5 SUD and DSM-IV dependence, and DSM-5 moderate-to-severe SUD and DSM-IV dependence.ResultsAgreement between DSM-5 and DSM-IV SUD was excellent for alcohol, cocaine, heroin, opioids, sedatives, and stimulants (κ=0.84; 0.91; 0.99; 0.96; 0.92; 0.97; respectively) and substantial for alcohol and tobacco (κ=0.75; 0.80, respectively). Agreement between DSM-5 SUD and DSM-IV substance dependence was excellent for cocaine, heroin, opioids, sedatives, and stimulants (κ=0.89; 0.97; 0.90; 0.88; 0.94, respectively) and substantial for alcohol, tobacco, and cannabis (κ=0.75; 0.69; 0.63, respectively). Agreement between moderate and severe DSM-5 SUD and DSM-IV dependence was excellent across all substances.ConclusionFindings suggest that while care should always be used in interpreting the results of studies using different methods, studies relying on DSM-IV or DSM-5 SUD diagnostic criteria can be considered to offer similar information and thus can be compared when accumulating a body of evidence on a particular issue regarding substance use.
Reliability of ADDIS for diagnoses of substance use disorders according to ICD-10, DSM-IV and DSM-5: test-retest and inter-item consistency