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

Article information

Korean J Health Promot. 2017;17(2):91-98
Publication date (electronic) : 2017 June 30
doi : https://doi.org/10.15384/kjhp.2017.17.2.91
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 2017 February 02; Accepted 2017 June 08.

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

Notes

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

Appendices

Appendix

Questionnaire for drinking habits investigation

References

1. Beseler CL, Taylor LA, Leeman RF. An item-response theory analysis of dsm-iv alcohol-use disorder criteria and “binge” drinking in undergraduates. J Stud Alcohol Drugs 2010;71(3):418–423.
2. Robin RW, Long JC, Rasmussen JK, Albaugh B, Goldman D. Relationship of binge drinking to alcohol dependence, other psychiatric disorders, and behavioral problems in an American Indian tribe. Alcohol Clin Exp Res 1998;22(2):518–523.
3. Knight JR, Wechsler H, Kuo M, Seibring M, Weitzman ER, Schuckit MA. Alcohol abuse and dependence among U.S. college students. J Stud Alcohol 2002;63(3):263–270.
4. Kim SG, Kim JS, Pack HJ, Sung HN. Usefulness of heavy drinking and binge drinking for the diagnosis of alcohol use disorder. Korean J Fam Med 2016;37(4):214–220.
5. Cherpitel CJ. Analysis of cut points for screening instruments for alcohol problems in the emergency room. J Stud Alcohol 1995;56(6):695–700.
6. Shibuya A, Yasunami M, Yoshida A. Genotypes of alcohol dehydrogenase and aldehyde dehydrogenase loci in Japanese alcohol flushers and nonflushers. Hum Genet 1989;82(1):14–16.
7. Jung JG, Kim JS, Oh MK. The role of the flushing response in the relationship between alcohol consumption and insulin resistance. Alcohol Clin Exp Res 2010;34(10):1699–1704.
8. Jung JG, Kim JS, Yoon SJ, Oh MK. Relationships among alcohol consumption, facial flushing response, and metabolic syndrome in healthy men. Ann Epidemiol 2012;22(7):480–486.
9. Suh HS, Kim JS, Kim SS, Jung JG, Yoon SJ, Ahn JB. Influence of the flushing response in the relationship between alcohol consumption and cardiovascular disease risk. Korean J Fam Med 2014;35(6):295–302.
10. Kim EC, Kim JS, Jung JG, Kim SS, Yoon SJ, Ryu JS. Effect of alcohol consumption on risk of hyperhomocysteinemia based on alcohol-related facial flushing response. Korean J Fam Med 2013;34(4):250–257.
11. Kim SG, Kim JS, Kim SS, Jung JG, Yun SJ, Kim EC. Relationships between the level of alcohol consumption and abnormality in biomarkers according to facial flushing in Korean male drinkers. Korean J Fam Med 2013;34(2):123–130.
12. Jung JG, Kim JS, Kim YS, Oh MK, Yoon SJ. Hypertension associated with alcohol consumption based on the facial flushing reaction to drinking. Alcohol Clin Exp Res 2014;38(4):1020–1025.
13. Kim JS. Guideline of moderate alcohol drinking amount for Koreans. Korean J Fam Pract 2015;5Suppl 1. :S117–S119.
14. National Institute of Alcohol Abuse and Alcoholism. Rethinking drinking: Alcohol and your health [Internet] Bethesda: Natio nal Institute of Alcohol Abuse and Alcoholism; 2016. Accessed June 25, 2017. Available from: https://pubs.niaaa.nih.gov/publications/RethinkingDrinking/Rethinking_Drinking.pdf.
15. Bouchery EE, Harwood HJ, Sacks JJ, Simon CJ, Brewer RD. Economic costs of excessive alcohol consumption in the U.S., 2006. Am J Prev Med 2011;41(5):516–524.
16. Naimi TS, Brewer RD, Mokdad A, Denny C, Serdula MK, Marks JS. Binge drinking among US adults. JAMA 2003;289(1):70–75.
17. Willenbring ML, Massey SH, Gardner MB. Helping patients who drink too much: an evidence-based guide for primary care physicians. Am Fam Physician 2009;80(1):44–50.
18. Muller MP, Tomlinson G, Marrie TJ, Tang P, McGeer A, Low DE, et al. Can routine laboratory tests discriminate between severe acute respiratory syndrome and other causes of community-acquired pneumonia? Clin Infect Dis 2005;40(8):1079–1086.
19. Song SW. Using the receiver operating characteristic (ROC) curve to measure sensitivity and specificity. Korean J Fam Med 2009;30(11):841–842.
20. Nam TW, Kim JS, Kim SS, Jung JG, Kang DS, Hyeon YH, et al. Utility of single alcohol questions related to binge drinking in identifying problem drinkers. Korean J Fam Med 2009;30(10):777–783.
21. McGee S. Simplifying likelihood ratios. J Gen Intern Med 2002;17(8):646–649.
22. Henderson MC, Tierney LM, Smetana GW. The patient history: an evidence based approach to differential diagnosis 2nd edth ed. New York: McGrawHill; 2012. p. 30.
23. Anderson ML, Nokia MS, Govindaraju KP, Shors TJ. Moderate drinking? Alcohol consumption significantly decreases neurogenesis in the adult hippocampus. Neuroscience 2012;224(8):202–209.

Article information Continued

Copyright © 2017 Korean Society for Health Promotion and Disease Prevention

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.

Figure 1

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

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

Table 1

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

Table 2

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

Table 3

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.