Department of Epidemiology, College of Human Medicine, Michigan State University, East Lansing, Michigan 48824, USA.
Ann N Y Acad Sci. 2010 Feb;1187:353-69. doi: 10.1111/j.1749-6632.2009.05419.x.
Stage-transition models based on the American Diagnostic and Statistical Manual (DSM) generally are applied in epidemiology and genetics research on drug dependence syndromes associated with cannabis, cocaine, and other internationally regulated drugs (IRDs). Difficulties with DSM stage-transition models have surfaced during cross-national research intended to provide a truly global perspective, such as the work of the World Mental Health Surveys Consortium. Alternative simpler dependence-related phenotypes are possible, including population-level count process models for steps early and before coalescence of clinical features into a coherent syndrome (e.g., zero-inflated Poisson [ZIP] regression). Selected findings are reviewed, based on ZIP modeling of alcohol, tobacco, and IRD count processes, with an illustration that may stimulate new research on genetic susceptibility traits. The annual National Surveys on Drug Use and Health (NSDUH) can be readily modified for this purpose, along the lines of a truly anonymous research approach that can help make NSDUH-type cross-national epidemiological surveys more useful in the context of subsequent genomewide association (GWAS) research and post-GWAS investigations with a truly global health perspective.
基于美国《精神障碍诊断与统计手册》（DSM）的阶段转换模型通常应用于与大麻、可卡因和其他国际管制药物（IRDs）相关的药物依赖综合征的流行病学和遗传学研究。在旨在提供真正全球视角的跨国研究中，如世界心理健康调查联盟的工作中，DSM 阶段转换模型遇到了困难。可能存在更简单的与依赖相关的表型，包括人群水平的计数过程模型，用于在临床特征合并为连贯综合征之前的早期步骤（例如，零膨胀泊松[ZIP]回归）。基于酒精、烟草和 IRD 计数过程的 ZIP 建模，综述了选定的发现，并举例说明可能会激发关于遗传易感性特征的新研究。可以为此目的对年度国家药物使用和健康调查（NSDUH）进行修改，遵循真正匿名的研究方法，这有助于使 NSDUH 类型的跨国流行病学调查在随后的全基因组关联（GWAS）研究和具有真正全球健康视角的 GWAS 后调查中更有用。
