title: Crosswalk between DSM-IV dependence and DSM-5 substance use disorders for opioids, cannabis, cocaine and alcohol.
abstract: BACKGROUND
  Ascertaining agreement between DSM-IV and DSM-5 is important to determine the applicability of treatments for DSM-IV conditions to persons diagnosed according to the proposed DSM-5.
  
  
  METHODS
  Data from a nationally representative sample of US adults were used to compare concordance of past-year DSM-IV opioid, cannabis, cocaine and alcohol dependence with past-year DSM-5 disorders at thresholds of 3+, 4+, 5+ and 6+ positive DSM-5 criteria among past-year users of opioids (n=264), cannabis (n=1622), cocaine (n=271) and alcohol (n=23,013). Substance-specific 2 × 2 tables yielded overall concordance (kappa), sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV).
  
  
  RESULTS
  For DSM-IV alcohol, cocaine and opioid dependence, optimal concordance occurred when 4+ DSM-5 criteria were endorsed, corresponding to the threshold for moderate DSM-5 alcohol, cocaine and opioid use disorders. Maximal concordance of DSM-IV cannabis dependence and DSM-5 cannabis use disorder occurred when 6+ criteria were endorsed, corresponding to the threshold for severe DSM-5 cannabis use disorder. At these optimal thresholds, sensitivity, specificity, PPV and NPV generally exceeded 85% (>75% for cannabis).
  
  
  CONCLUSIONS
  Overall, excellent correspondence of DSM-IV dependence with DSM-5 substance use disorders was documented in this general population sample of alcohol, cannabis, cocaine and opioid users. Applicability of treatments tested for DSM-IV dependence is supported by these results for those with a DSM-5 alcohol, cocaine or opioid use disorder of at least moderate severity or severe cannabis use disorder. Further research is needed to provide evidence for applicability of treatments for persons with milder substance use disorders.
authors: Division of Epidemiology, Services and Prevention Research, National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA. wcompton@nida.nih.gov
authors: Wilson M
authors: WM
authors: Compton
authors: Deborah A
authors: DA
authors: Dawson
authors: Risë B
authors: RB
authors: Goldstein
authors: Bridget F
authors: BF
authors: Grant
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D019970:Cocaine-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D012015:Reference Standards; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Concordance; DSM-5; DSM-IV; Diagnosis; Kappa; Substance use disorder
references: Drug Alcohol Depend. 1998 Mar 1;50(1):19-26
references: 9589269
references: Curr Pharm Des. 2011;17(14):1359-68
references: 21524259
references: Addiction. 2011 May;106(5):941-50
references: 21205055
references: Arch Gen Psychiatry. 2007 May;64(5):566-76
references: 17485608
references: Drugs. 2012 Jan 22;72(2):217-28
references: 22235870
references: Neuropsychopharmacology. 2012 Jun;37(7):1689-98
references: 22373942
references: Addict Biol. 2013 Nov;18(6):993-1002
references: 22741619
references: Curr Drug Abuse Rev. 2012 Mar;5(1):3-31
references: 22126708
references: Arch Gen Psychiatry. 2007 Jul;64(7):830-42
references: 17606817
references: J Subst Abuse Treat. 2012 Oct;43(3):303-12
references: 22377391
references: Addict Biol. 2012 May;17(3):513-27
references: 22458728
references: Contemp Clin Trials. 2012 Sep;33(5):993-1002
references: 22613054
references: Pharmacol Ther. 2012 May;134(2):260-77
references: 22327234
references: Drug Alcohol Depend. 1995 Jul;39(1):37-44
references: 7587973
references: Addict Behav. 2012 Aug;37(8):900-7
references: 22578380
references: Alcohol Clin Exp Res. 2013 Jan;37 Suppl 1:E305-13
references: 22974144
references: Addiction. 2011 Nov;106(11):1935-43
references: 21631621
references: Drug Alcohol Depend. 2012 Dec 1;126(3):384-8
references: 22728044