Hasin D, McCloud S, Li Q, Endicott J
Columbia University College of Physicians and Surgeons (Department of Psychiatry), New York 10032, USA.
Drug Alcohol Depend. 1996 Jun;41(2):127-35. doi: 10.1016/0376-8716(96)01232-x.
Increasing importance is being placed on the appropriateness of methodologies for different population subgroups, such as women as well as men, non-Whites as well as Whites, and older and younger individuals. In the alcohol field, this applies to a number of areas, including the agreement between diagnoses of alcohol use disorders by different sets of diagnostic criteria. We tested the agreement between DSM-III, DSM-III-R, DSM-IV and ICD-10 criteria for alcohol dependence and abuse in demographic subgroups of a sample of 962 community residents screened for heavy drinking in the previous 12 months. Good to excellent agreement was found for current diagnoses of dependence across all subgroups and classification systems. For past diagnoses, agreement was good across all subgroups for comparisons that did not involve DSM-III, and quite low for comparisons of DSM-III to other classification systems across subgroups. With few exceptions, cross-system agreement for diagnoses of alcohol abuse was poor. This result was also consistent across demographic subgroups. Results suggest that studies can be compared equally well for diagnoses of alcohol dependence subsequent to DSM-III for males and females. Whites and non-Whites, and older and younger respondents. Abuse remains a problematic category psychometrically across all demographic categories, even in this sample of largely untreated household residents.
不同人群亚组（如男性与女性、非白人与白人、老年人与年轻人）方法的适宜性正受到越来越多的重视。在酒精研究领域，这适用于多个方面，包括不同诊断标准对酒精使用障碍的诊断一致性。我们在一个962名社区居民的样本中，检测了《精神疾病诊断与统计手册》第三版（DSM-III）、《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）、《精神疾病诊断与统计手册》第四版（DSM-IV）和国际疾病分类第十版（ICD-10）关于酒精依赖和滥用的诊断标准在人口统计学亚组中的一致性。在所有亚组和分类系统中，当前依赖诊断的一致性良好至优秀。对于过去的诊断，在所有亚组中，不涉及DSM-III的比较一致性良好，而在亚组间将DSM-III与其他分类系统进行比较时，一致性相当低。除少数例外，酒精滥用诊断的跨系统一致性较差。这一结果在各人口统计学亚组中也一致。结果表明，对于DSM-III之后的酒精依赖诊断，男性与女性、白人与非白人、老年与年轻受访者的研究可以同样好地进行比较。即使在这个主要是未经治疗的家庭居民样本中，滥用在所有人口统计学类别中在心理测量学上仍然是一个有问题的类别。
