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<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">Korean J Health Promot</journal-id>
<journal-id journal-id-type="publisher-id">KJHP</journal-id>
<journal-title-group>
<journal-title>Korean Journal of Health Promotion</journal-title>
</journal-title-group>
<issn pub-type="ppub">2234-2141</issn>
<issn pub-type="epub">2093-5676</issn>
<publisher>
<publisher-name>Korean Society for Health Promotion and Disease Prevention</publisher-name>
</publisher>
</journal-meta>

<article-meta>
<article-id pub-id-type="doi">10.15384/kjhp.2017.17.2.91</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Original Article</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Diagnostic Usefulness of Korean Standard on Heavy Drinking for the DSM-5 Alcohol Use Disorder</article-title>
</title-group>

<contrib-group>

<contrib contrib-type="author">
<name>
<surname>Kim</surname>
<given-names>Seong Gu</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>

<contrib contrib-type="author" corresp="yes">
<name>
<surname>Kim</surname>
<given-names>Jong Sung</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>

<contrib contrib-type="author">
<name>
<surname>Pack</surname>
<given-names>Han Ju</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>

<contrib contrib-type="author">
<name>
<surname>Sung</surname>
<given-names>Han Na</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
</contrib-group>

<aff id="A1"><label>1</label>Department of Family Medicine, Sun Healthcare International, Yuseong Sun Hospital, Daejeon, Korea.</aff>
<aff id="A2"><label>2</label>Department of Family Medicine, Research Institute for Medical Sciences, Chungnam National University School of Medicine, Daejeon, Korea.</aff>

<author-notes>
<corresp>
Corresponding author: Jong Sung Kim, MD, PhD. Department of Family Medicine, Research Institute for Medical Sciences, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon 35015, Korea. Tel: +82-42-280-8172, Fax: +82-42-280-7879, <email>josephkim@cnu.ac.kr</email></corresp>
</author-notes>

<pub-date pub-type="ppub">
<month>06</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>06</month>
<year>2017</year>
</pub-date>
<volume>17</volume>
<issue>2</issue>
<fpage>91</fpage>
<lpage>98</lpage>

<history>
<date date-type="received">
<day>02</day>
<month>02</month>
<year>2017</year>
</date>
<date date-type="accepted">
<day>08</day>
<month>06</month>
<year>2017</year>
</date>
</history>

<permissions>
<copyright-statement>Copyright &#x00A9; 2017 Korean Society for Health Promotion and Disease Prevention</copyright-statement>
<copyright-year>2017</copyright-year>
<license license-type="open-access" xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">
<license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<ext-link ext-link-type="uri" xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</ext-link>) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>

<abstract>
<sec>
<title>Background</title>
<p>This research investigated the usefulness of heavy drinking standards of &#x2018;guidelines for moderate alcohol drinking amount for Koreans&#x2019; for diagnosis of Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) alcohol use disorder.</p>
</sec>
<sec>
<title>Methods</title>
<p>This retrospective study was conducted with 976 adults who visited an health screening center in Daejeon for health check-up in 2015. Daily drinking amount, drinking frequency per week, and weekly drinking amount were investigated. Using the heavy drinking criteria of Korean guideline, participants were grouped by age and gender and classified as normal or heavy drinkers. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), Positive likelihood ratio (LR+), Negative likelihood ratio (LR-), odds ratio (OR) and Youden's Index of heavy drinking according to Korean guideline for diagnosis of DSM-5 alcohol use disorder were calculated.</p>
</sec>
<sec>
<title>Results</title>
<p>The Area under the receiver operating characteristic (ROC) curve of a model screening DSM-5 alcohol use disorder by weekly drinking amount were 0.812 in males up to age 65 years and 0.931 in males over age 65 years and females respectively. The sensitivity, specificity, PPV and NPV of Korean guideline heavy drinking group for diagnosis of DSM-5 alcohol use disorder were 61.0%, 89.7%, 67.0%, and 87.05% respectively. The LR+, LR-, OR and Youden's Index of those were 5.917 (4.704-7.435), 0.434 (0.379-0.497), 13.623 (9.607-19.317), and 0.507 respectively.</p>
</sec>
<sec>
<title>Conclusions</title>
<p>This research shows the Korean heavy drinking standard is useful for diagnosis of DSM-5 alcohol use disorder in Korean people.</p>
</sec>
</abstract>

<kwd-group>
<kwd>Alcohol drinking</kwd>
<kwd>DSM-5</kwd>
<kwd>Sensitivity</kwd>
<kwd>Specificity</kwd>
</kwd-group>

</article-meta>
</front>

<back>

<fn-group>
<fn fn-type="other">
<p><sup>*</sup> This manuscript is based on the first author's doctoral dissertation from Chungnam National University.</p>
</fn>
</fn-group>

<app-group>
<app id="APP1">
<title>Appendix</title>
<sec>
<title>Questionnaire for drinking habits investigation</title>
<p><graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="kjhp-17-91-a001"></graphic></p>
</sec>
</app>
</app-group>

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</back>

<floats-group>

<fig position="float" id="F1">
<label>Figure 1</label>
<caption>
<title>ROC curves of a model screening DSM-5 alcohol use disorder by weekly drinking amount in males up to age 65 years.</title>
</caption>
<graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="kjhp-17-91-g001"></graphic>
</fig>

<fig position="float" id="F2">
<label>Figure 2</label>
<caption>
<title>ROC curves of a model screening DSM-5 alcohol use disorder by weekly drinking amount in males over age 65 years and females.</title>
</caption>
<graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="kjhp-17-91-g002"></graphic>
</fig>

<table-wrap position="float" id="T1">
<label>Table 1</label>
<caption>
  <title>Characteristics of subjects</title>
</caption>
<graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="kjhp-17-91-i001"></graphic>
<table-wrap-foot>
<fn>
  <p>Abbreviation: DSM-5, Diagnostic and Statistical Manual of Mental Disorders 5th edition.</p>
  <p>Values are presented as median (interquartile range) or n (%).</p>
<p><sup>a</sup>Heavy alcohol drinking group for males up to age 65 years according to Korean guideline: over 8 drinks in a week. Heavy alcohol drinking group for males over age 65 years and females according to Korean guideline: over 4 drinks in a week.</p>
  <p><sup>b</sup>By independent samples Mann-Whitney U-test or &#x03C7;<sup>2</sup> test.</p>
  <p><sup>c</sup>1 standard drink: ethanol 14 g.</p>
</fn>
</table-wrap-foot>
</table-wrap>

<table-wrap position="float" id="T2">
<label>Table 2</label>
<caption>
  <title>Alcohol drinking by age group</title>
</caption>
<graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="kjhp-17-91-i002"></graphic>
<table-wrap-foot>
<fn>
  <p>Abbreviation: DSM-5, Diagnostic and Statistical Manual of Mental Disorders 5th edition.</p>
  <p>Values are presented as n (%).</p>
  <p><sup>a</sup>By &#x03C7;<sup>2</sup> test.</p>
</fn>
</table-wrap-foot>
</table-wrap>

<table-wrap position="float" id="T3">
<label>Table 3</label>
<caption>
<title>Sensitivity, specificity, PPV, NPV, LR+, LR-, OR and Youden's index of Korean heavy drinking standard for DSM-5 alcohol use disorder diagnosis</title>
</caption>
<graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="kjhp-17-91-i003"></graphic>
<table-wrap-foot>
<fn>
<p>Abbreviations: PPV, positive predictive value; NPV, negative predictive value; LR+, positive likelihood ratio; LR-, negative likelihood ratio; OR, odds ratio; CI, confidence interval.</p>
  <p><sup>a</sup>Heavy alcohol drinking group for males up to age 65 years according to Korean guideline: over 8 drinks in a week.</p>
<p><sup>b</sup>Heavy alcohol drinking group for males over age 65 years and females according to Korean guideline: over 4 drinks in a week.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</floats-group>


</article>