title: Inter-observer reliability of DSM-5 substance use disorders.
abstract: OBJECTIVE
  Although studies have examined the impact of changes made in DSM-5 on the estimated prevalence of substance use disorder (SUD) diagnoses, there is limited evidence concerning the reliability of DSM-5 SUDs. We evaluated the inter-observer reliability of four DSM-5 SUDs in a sample in which we had previously evaluated the reliability of DSM-IV diagnoses, allowing us to compare the two systems.
  
  
  METHODS
  Two different interviewers each assessed 173 subjects over a 2-week period using the Semi-Structured Assessment for Drug Dependence and Alcoholism (SSADDA). Using the percent agreement and kappa (κ) coefficient, we examined the reliability of DSM-5 lifetime alcohol, opioid, cocaine, and cannabis use disorders, which we compared to that of SSADDA-derived DSM-IV SUD diagnoses. We also assessed the effect of additional lifetime SUD and lifetime mood or anxiety disorder diagnoses on the reliability of the DSM-5 SUD diagnoses.
  
  
  RESULTS
  Reliability was good to excellent for the four disorders, with κ values ranging from 0.65 to 0.94. Agreement was consistently lower for SUDs of mild severity than for moderate or severe disorders. DSM-5 SUD diagnoses showed greater reliability than DSM-IV diagnoses of abuse or dependence or dependence only. Co-occurring SUD and lifetime mood or anxiety disorders exerted a modest effect on the reliability of the DSM-5 SUD diagnoses.
  
  
  CONCLUSIONS
  For alcohol, opioid, cocaine and cannabis use disorders, DSM-5 criteria and diagnoses are at least as reliable as those of DSM-IV.
authors.affiliation: Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, United States.
authors.forename: Cécile M
authors.initials: CM
authors.lastname: Denis
authors.affiliation: Departments of Psychiatry (Division of Human Genetics), Neurobiology, and Genetics, Yale University School of Medicine, New Haven, CT, United States; VA Connecticut Healthcare System, West Haven, CT 06516, United States.
authors.forename: Joel
authors.initials: J
authors.lastname: Gelernter
authors.affiliation: Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, United States.
authors.forename: Amy B
authors.initials: AB
authors.lastname: Hart
authors.affiliation: Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, United States; VISN4 MIRECC, Philadelphia VAMC, Philadelphia, PA 19104, United States. Electronic address: kranzler@mail.med.upenn.edu.
authors.forename: Henry R
authors.initials: HR
authors.lastname: Kranzler
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000150:complications / Q000175:diagnosis; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000150:complications / Q000175:diagnosis; D015588:Observer Variation; D019966:Substance-Related Disorders / Q000150:complications / Q000175:diagnosis*
keywords: Anxiety disorde; DSM-5; Mood disorder; Reliability; Substance use disorder