酒精使用障碍及相关残疾访谈表-5（AUDADIS-5）：通过对一般人群样本进行临床重新评估来验证物质使用障碍模块的程序有效性。
The Alcohol Use Disorder and Associated Disabilities Interview Schedule-5 (AUDADIS-5): procedural validity of substance use disorders modules through clinical re-appraisal in a general population sample.
作者信息
Hasin Deborah S, Greenstein Eliana, Aivadyan Christina, Stohl Malki, Aharonovich Efrat, Saha Tulshi, Goldstein Rise, Nunes Edward V, Jung Jeesun, Zhang Haitao, Grant Bridget F
机构信息
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA; New York State Psychiatric Institute, New York, NY 10032, USA.
New York State Psychiatric Institute, New York, NY 10032, USA.
出版信息
Drug Alcohol Depend. 2015 Mar 1;148:40-6. doi: 10.1016/j.drugalcdep.2014.12.011. Epub 2014 Dec 18.
BACKGROUND
The purpose of this study was to assess the procedural validity of the substance disorder modules of the lay-administered Alcohol Use Disorder and Associated Disabilities Interview Schedule, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Version (AUDADIS-5) through clinician re-appraisal re-interviews.
METHODS
The study employed a test-retest design among 712 respondents from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III). A clinician-administered, semi-structured interview, the Psychiatric Research Interview for Substance and Mental Disorders, DSM-5 version (PRISM-5) was used as the re-appraisal. Kappa coeffients indicated concordance of the AUDADIS-5 and PRISM-5 for DSM-5 substance use disorder diagnoses, while intraclass correlation coefficients (ICC) indicated concordance on dimensional scales indicating the DSM-5 criteria count for each disorder.
RESULTS
With few exceptions, concordance of the AUDADIS-5 and the PRISM-5 for DSM-5 diagnoses of substance use disorders ranged from fair to good (κ=0.40-0.72). Concordance on dimensional scales was excellent (ICC≥0.75) for the majority of DSM-5 SUD diagnoses, and fair to good (ICC=0.43-0.72) for most of the rest.
CONCLUSIONS
As indicated by concordance with a semi-structured clinician-administered re-appraisal, the procedural validity of the AUDADIS-5 DSM-5 substance use disorder diagnoses found in this study indicates that these AUDADIS-5 diagnoses are useful tools in epidemiologic studies. The considerably stronger concordance of the AUDADIS-5 and PRISM-5 dimensional DSM-5 SUD measures supports a current movement to place more emphasis on dimensional measures of psychopathology, and suggests that such measures may be more informative than binary diagnoses for research, and possibly for clinical purposes as well.
背景
本研究旨在通过临床医生重新评估再访谈来评估由非专业人员实施的《酒精使用障碍及相关残疾访谈表，精神疾病诊断与统计手册，第五版（DSM-5）版本》（AUDADIS-5）中物质使用障碍模块的程序效度。
方法
该研究在来自全国酒精及相关疾病流行病学调查三期（NESARC-III）的712名受访者中采用了重测设计。使用临床医生实施的半结构化访谈《物质与精神障碍的精神病学研究访谈，DSM-5版本》（PRISM-5）作为重新评估。卡帕系数表明了AUDADIS-5和PRISM-5在DSM-5物质使用障碍诊断方面的一致性，而组内相关系数（ICC）表明了在维度量表上的一致性，该量表显示了每种障碍的DSM-5标准计数。
结果
除少数例外情况外，AUDADIS-5和PRISM-5在DSM-5物质使用障碍诊断方面的一致性从一般到良好（κ=0.40 - 0.72）。对于大多数DSM-5物质使用障碍诊断，维度量表上的一致性极佳（ICC≥0.75），而对于其他大多数诊断则为一般到良好（ICC = 0.43 - 0.72）。
结论
正如与临床医生实施的半结构化重新评估的一致性所表明的那样，本研究中发现的AUDADIS-5 DSM-5物质使用障碍诊断的程序效度表明，这些AUDADIS-5诊断是流行病学研究中的有用工具。AUDADIS-5和PRISM-5维度DSM-5物质使用障碍测量之间更强的一致性支持了当前更加强调精神病理学维度测量的趋势，并表明此类测量对于研究可能比二元诊断更具信息性，并可能也适用于临床目的。
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