Diagnostic Usefulness of Korean Standard on Heavy Drinking for the DSM-5 Alcohol Use Disorder

Seong Gu Kim; Jong Sung Kim; Han Ju Pack; Han Na Sung

doi:10.15384/kjhp.2017.17.2.91

Korean J Health Promot > Volume 17(2); 2017 > Article

Kim, Kim, Pack, and Sung: Diagnostic Usefulness of Korean Standard on Heavy Drinking for the DSM-5 Alcohol Use Disorder

Original Article

Korean Journal of Health Promotion 2017;17(2):91-98.

Published online: June 30, 2017

DOI: https://doi.org/10.15384/kjhp.2017.17.2.91

Diagnostic Usefulness of Korean Standard on Heavy Drinking for the DSM-5 Alcohol Use Disorder

Seong Gu Kim¹, Jong Sung Kim²

, Han Ju Pack¹, Han Na Sung¹

¹Department of Family Medicine, Sun Healthcare International, Yuseong Sun Hospital, Daejeon, Korea.

²Department of Family Medicine, Research Institute for Medical Sciences, Chungnam National University School of Medicine, Daejeon, Korea.

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, josephkim@cnu.ac.kr

Received February 02, 2017 Accepted June 08, 2017

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

ABSTRACT

Background

This research investigated the usefulness of heavy drinking standards of ‘guidelines for moderate alcohol drinking amount for Koreans’ for diagnosis of Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) alcohol use disorder.

Methods

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.

Results

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.

Conclusions

This research shows the Korean heavy drinking standard is useful for diagnosis of DSM-5 alcohol use disorder in Korean people.

Keywords: Alcohol drinking, DSM-5, Sensitivity, Specificity

^* This manuscript is based on the first author's doctoral dissertation from Chungnam National University.

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Appendices

Appendix

Questionnaire for drinking habits investigation

Figure 1

ROC curves of a model screening DSM-5 alcohol use disorder by weekly drinking amount in males up to age 65 years.

Figure 2

ROC curves of a model screening DSM-5 alcohol use disorder by weekly drinking amount in males over age 65 years and females.

Table 1

Characteristics of subjects

Abbreviation: DSM-5, Diagnostic and Statistical Manual of Mental Disorders 5th edition.

Values are presented as median (interquartile range) or n (%).

^aHeavy 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.

^bBy independent samples Mann-Whitney U-test or χ² test.

^c1 standard drink: ethanol 14 g.

Table 2

Alcohol drinking by age group

Abbreviation: DSM-5, Diagnostic and Statistical Manual of Mental Disorders 5th edition.

Values are presented as n (%).

^aBy χ² test.

Table 3

Sensitivity, specificity, PPV, NPV, LR+, LR-, OR and Youden's index of Korean heavy drinking standard for DSM-5 alcohol use disorder diagnosis

Abbreviations: PPV, positive predictive value; NPV, negative predictive value; LR+, positive likelihood ratio; LR-, negative likelihood ratio; OR, odds ratio; CI, confidence interval.

^aHeavy alcohol drinking group for males up to age 65 years according to Korean guideline: over 8 drinks in a week.

^bHeavy alcohol drinking group for males over age 65 years and females according to Korean guideline: over 4 drinks in a week.