title: Cocaine use disorder prevalence: From current DSM-IV to proposed DSM-5 diagnostic criteria with both a two and three severity level classification system.
abstract: This article presents a secondary analysis from a study investigating the compatibility of the current DSM-IV and previously proposed DSM-5 cocaine use disorder (CUD) criteria (S. L. Proctor, A. M. Kopak, & N. G. Hoffmann, 2012, Compatibility of current DSM-IV and proposed DSM-5 diagnostic criteria for cocaine use disorders. Addictive Behaviors, 37, 722-728). The current analyses examined the compatibility of the current DSM-IV and two sets of proposed DSM-5 diagnostic criteria for CUDs among adult male inmates (N = 6,871) recently admitted to the Minnesota Department of Corrections state prison system from 2000-2003. Initially proposed DSM-5 criteria (DSM-5.0) featured only two diagnostic designations (i.e., moderate and severe). A subsequent revision (DSM-5.1) included the addition of a mild designation and required a greater number of positive findings for the severe designation. A computer-prompted structured diagnostic interview was administered to all inmates as part of routine clinical assessments. The past 12-month prevalence of DSM-IV CUDs was 12.70% (Abuse, 3.78%, Dependence, 8.92%), while 10.98% met past 12-month DSM-5.1 criteria for a CUD (Mild [MiCUD], 1.72%; Moderate [MCUD], 1.12%; and Severe [SCUD], 8.14%). The vast majority of those with no diagnosis (99.6%) continued to have no diagnosis, and most of those with a dependence diagnosis (91.2%) met SCUD criteria of the proposed DSM-5.1. Most of the variation in DSM-5.1 diagnostic classifications was accounted for by those with a current abuse diagnosis. DSM-5.0 MCUD cases were most affected when DSM-5.1 criteria were applied. The proposed diagnostic changes might translate to reduced access to treatment for those individuals evincing symptoms consistent with DSM-IV cocaine abuse.
authors.affiliation: Department of Psychology.
authors.forename: Steven L
authors.initials: SL
authors.lastname: Proctor
authors.affiliation: Department of Criminology and Criminal Justice, Western Carolina University.
authors.forename: Albert M
authors.initials: AM
authors.lastname: Kopak
authors.affiliation: Department of Psychology, Western Carolina University.
authors.forename: Norman G
authors.initials: NG
authors.lastname: Hoffmann
mesh_terms: D000328:Adult; D019970:Cocaine-Related Disorders / Q000145:classification* / Q000453:epidemiology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D015995:Prevalence; D011329:Prisoners / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D055815:Young Adult