Test-re-test reliability of DSM-IV adopted criteria for 3,4-methylenedioxymethamphetamine (MDMA) abuse and dependence: a cross-national study.
OBJECTIVE
This study evaluated the prevalence and reliability of DSM-IV adopted criteria for 3,4-methylenedioxymethamphetamine (MDMA) abuse and dependence with a purpose to determine whether it is best conceptualized within the category of hallucinogens, amphetamines or its own category.


METHODS
Test-re-test study.


METHODS
MDMA users (life-time use >5 times) were recruited in St Louis, Miami and Sydney (n=593). The median life-time MDMA consumption was 50 pills at the baseline.


METHODS
The computerized Substance Abuse Module for Club Drug (CD-SAM) was used to assess MDMA abuse and dependence. The Discrepancy Interview Protocol (DIP) was used to determine the reasons for the discrepant responses between the two interviews. Reliability of diagnoses, individual diagnostic criteria and withdrawal symptoms was examined using the kappa coefficient (κ). findings for baseline data, 15% and 59% met MDMA abuse and dependence, respectively. Substantial test-re-test reliability of the diagnoses was observed consistently across cities (κ=0.69). 'Continued use despite knowledge of physical/psychological problems' (87%) and 'withdrawal' (68%) were the two most prevalent dependence criteria. 'Physically hazardous use' was the most prevalent abuse criterion. Six dependence criteria and all abuse criteria were reported reliably across cities (κ: 0.53-0.77). Seventeen of 19 withdrawal symptoms showed consistency in the reliability across cities. The most commonly reported reason for discrepant responses was 'interpretation of question changed'. Only a small proportion of the total discrepancies were attributed to lying or social desirability.


CONCLUSIONS
The adopted DSM-IV diagnostic classification for MDMA abuse and dependence was moderately reliable across cities. findings on MDMA withdrawal support the argument that MDMA should be separated from other hallucinogens in DSM.
Cottler
Linda B
LB
Epidemiology and Prevention Research Group, Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63108, USA. cottler@epi.wustl.edu
Leung
Kit Sang
KS
Abdallah
Arbi Ben
AB
D000293:Adolescent; D000328:Adult; D001315:Australia / Q000453:epidemiology; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006213:Hallucinogens / Q000009:adverse effects*; D006801:Humans; D038622:Internationality; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000009:adverse effects*; D015203:Reproducibility of Results; D013375:Substance Withdrawal Syndrome / Q000145:classification* / Q000175:diagnosis / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000145:classification* / Q000175:diagnosis / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014505:Urban Population; D055815:Young Adult
D006213:Hallucinogens; D018817:N-Methyl-3,4-methylenedioxyamphetamine
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