WHO Study on the reliability and validity of the alcohol and drug use disorder instruments: overview of methods and results |
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| Institution: | 1. Unit on Epidemiology, Classification and Assessment, Division of Mental Health and Prevention of Substance Abuse, World Health Organization, 1211 Geneva 27, Switzerland;2. Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA;3. Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, USA;4. Department of Psychiatry, University College Hospital, Ibadan, Nigeria;5. Department of Psychiatry, Hacettepe University, Ankara, Turkey;6. Department of Psychiatry, University of Athens, Athens, Greece;7. Clinical Research Unit for Anxiety Disorders, St Vincent''s Hospital, Darlinghurst, NSW, Australia;8. Service de Neuropsychiatrie, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg;9. Department of Psychiatry, Royal Prince Alfred Hospital, Camperdown, NSW, Australia;10. Inspectorate for Health Care, Ministry of Health, Welfare and Sports, Rijswijk, The Netherlands;11. Office of the Dean for Academic Affairs, Behavioural Sciences Research Institute, San Juan, Puerto Rico;12. Psychiatric Hospital, Timis, Romania;13. Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, USA;14. Addiction Research Foundation, Toronto, Ontario, Canada;15. Amsterdam Institute for Addiction Research, University of Amsterdam, Amsterdam, The Netherlands;p. Division of Epidemiology and Services Research, NIMH, Rockville, MD, USA;q. Division of Clinical Research, National Institute on Drug Abuse, Rockville, MD, USA;r. Division of Biometry and Epidemiology, National Institute of Alcohol Abuse and Alcoholism, Rockville, MD, USA;s. Department of Psychiatry, University of Geneva, Geneva, Switzerland |
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| Abstract: | The WHO Study on the reliability and validity of the alcohol and drug use disorder instruments is an international study which has taken place in 12 centres in ten countries, aiming to test the reliability and validity of three diagnostic instruments for alcohol and drug use disorders: the Composite International Diagnostic Interview (CIDI), the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and a special version of the Alcohol Use Disorder and Associated Disabilities Interview schedule-alcohol/drug-revised (AUDADIS-ADR). The purpose of the reliability and validity (R&V) study is to further develop the alcohol and drug sections of these instruments so that a range of substance-related diagnoses can be made in a systematic, consistent, and reliable way. The study focuses on new criteria proposed in the tenth revision of the International Classification of Diseases (ICD-10) and the fourth revision of the diagnostic and statistical manual of mental disorders (DSM-IV) for dependence, harmful use and abuse categories for alcohol and psychoactive substance use disorders. A systematic study including a scientifically rigorous measure of reliability (i.e. 1 week test-retest reliability) and validity (i.e. comparison between clinical and non-clinical measures) has been undertaken. Results have yielded useful information on reliability and validity of these instruments at diagnosis, criteria and question level. Overall the diagnostic concordance coefficients (kappa, κ) were very good for dependence disorders (0.7–0.9), but were somewhat lower for abuse and harmful use categories. The comparisons among instruments and independent clinical evaluations and debriefing interviews gave important information about possible sources of unreliability, and provided useful clues on the applicability and consistency of nosological concepts across cultures. |
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