DSM-5 物质障碍测量的重测信度，使用 PRISM-5 进行评估，这是一种由临床医生管理的诊断访谈。
Test-retest reliability of DSM-5 substance disorder measures as assessed with the PRISM-5, a clinician-administered diagnostic interview.
机构信息
New York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032, USA; Department of Psychiatry, Columbia University Medical Center, 1051 Riverside Dr, New York, NY, 10032, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY, 10032, USA.
New York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032, USA; Department of Psychiatry, Columbia University Medical Center, 1051 Riverside Dr, New York, NY, 10032, USA.
出版信息
Drug Alcohol Depend. 2020 Nov 1;216:108294. doi: 10.1016/j.drugalcdep.2020.108294. Epub 2020 Sep 15.
AIM
In DSM-5, the definitions of substance use disorders (SUD) were changed considerably, yet little is known about the reliability of DSM-5 SUD and its new features.
METHODS
The test-retest reliability of DSM-5 SUD and DSM-IV substance dependence (SD) was evaluated in 565 adult substance users, each interviewed twice by different clinician interviewers using the semi-structured Psychiatric Research Interview for Substance and Mental Disorders, DSM-5 version (PRISM-5). DSM-5 SUD and DSM-IV SD criteria were assessed for past year and lifetime, yielding diagnoses and severity levels for alcohol, tobacco, cannabis, cocaine, heroin, opioids, sedatives, hallucinogen, and stimulant use disorders. Cohen's and intraclass correlation coefficients (ICC) assessed reliability for categorical and graded outcomes, respectively. Factors potentially influencing reliability were explored, including inpatient vs. community participant, days between interviews gender, age, race/ethnicity, and SUD severity.
RESULTS
DSM-5 SUD diagnoses had substantial to excellent reliability for most substances (κ = 0.63-0.94), and moderate for others (hallucinogens, stimulants, sedatives; κ = 0.50-0.59). For graded outcomes (DSM-5 SUD mild, moderate, severe; criteria count 0-11), reliability was substantial to excellent (ICC = 0.74-0.99). Comparisons of DSM-5 SUD and DSM-IV SD reliability showed few significant differences. Reliability of the DSM-5 craving criterion was excellent for heroin (κ = 0.84-0.95) and moderate to substantial for other substances (κ = 0.49-0.76). The only factor influencing reliability of SUD was severity, with milder disorders significantly more likely to be discordant between the interviews.
CONCLUSION
Reproducibility is crucial to good measurement. In a large sample using rigorous methodology, diagnoses and dimensional measures from clinician-administered interviews for DSM-5 SUD were generally highly reliable.
目的
在 DSM-5 中，物质使用障碍（SUD）的定义发生了重大变化，但对于 DSM-5 SUD 的可靠性及其新特征知之甚少。
方法
使用半结构式精神疾病研究访谈用物质和精神障碍 DSM-5 版（PRISM-5），对 565 名成年物质使用者进行了两次由不同临床访谈员进行的 DSM-5 SUD 和 DSM-IV 物质依赖（SD）的测试-重测信度评估。评估了 DSM-5 SUD 和 DSM-IV SD 标准在过去一年和一生中的情况，得出了酒精、烟草、大麻、可卡因、海洛因、阿片类药物、镇静剂、致幻剂和兴奋剂使用障碍的诊断和严重程度级别。分别使用 Cohen 的κ和组内相关系数（ICC）评估了分类和分级结果的可靠性。探讨了可能影响可靠性的因素，包括住院患者与社区参与者、访谈之间的天数、性别、年龄、种族/民族和 SUD 严重程度。
结果
DSM-5 SUD 诊断对大多数物质具有较高至极好的可靠性（κ=0.63-0.94），而对其他物质则为中度可靠性（致幻剂、兴奋剂、镇静剂；κ=0.50-0.59）。对于分级结果（DSM-5 SUD 轻度、中度、重度；标准计数 0-11），可靠性为高至极好（ICC=0.74-0.99）。DSM-5 SUD 和 DSM-IV SD 可靠性的比较显示出很少有显著差异。海洛因的 DSM-5 渴求标准的可靠性为极好（κ=0.84-0.95），其他物质的可靠性为中度至极好（κ=0.49-0.76）。唯一影响 SUD 可靠性的因素是严重程度，较轻的障碍在两次访谈之间明显更有可能不一致。
结论
可重复性对于良好的测量至关重要。在使用严格方法学的大样本中，使用临床医生管理的访谈进行 DSM-5 SUD 的诊断和维度测量通常具有高度可靠性。
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