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Differences in the Prevalence and Profile of DSM-IV and DSM-5 Alcohol Use Disorders—Results from the Singapore Mental Health Study 2016

Author

Listed:
  • Mythily Subramaniam

    (Research Division, Institute of Mental Health, Singapore 539747, Singapore
    Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore)

  • Edimansyah Abdin

    (Research Division, Institute of Mental Health, Singapore 539747, Singapore)

  • Alexander Man Cher Kong

    (Duke-NUS Medical School, Singapore 169857, Singapore)

  • Janhavi Ajit Vaingankar

    (Research Division, Institute of Mental Health, Singapore 539747, Singapore)

  • Anitha Jeyagurunathan

    (Research Division, Institute of Mental Health, Singapore 539747, Singapore)

  • Saleha Shafie

    (Research Division, Institute of Mental Health, Singapore 539747, Singapore)

  • Rajeswari Sambasivam

    (Research Division, Institute of Mental Health, Singapore 539747, Singapore)

  • Daniel Shuen Sheng Fung

    (Medical Board, Institute of Mental Health, Singapore 539747, Singapore)

  • Swapna Verma

    (Medical Board, Institute of Mental Health, Singapore 539747, Singapore)

  • Siow Ann Chong

    (Research Division, Institute of Mental Health, Singapore 539747, Singapore)

Abstract

Introduction: The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria for alcohol use disorders (AUD) was a significant shift from the historical DSM-IV Text Revised version. Following this shift in diagnostic criteria, a difference in the prevalence of AUD was expected. The current study aimed to evaluate the consequences of the modification of the diagnostic criteria from DSM-IV to DSM-5 AUD using lifetime diagnosis in Singapore’s multi-ethnic population using data from a nationwide epidemiological study. Methods: Respondents were assessed for lifetime mental disorders using the Composite International Diagnostic Interview (CIDI) administered through face-to-face interviews. Lifetime DSM-IV AUD diagnoses were compared with DSM-5 AUD diagnoses generated by modifying the criteria and the addition of the craving criterion. Sociodemographic correlates of lifetime DSM-IV/DSM-5 AUD were examined using multiple logistic regression analysis. Associations between DSM-IV/DSM-5 AUD, chronic conditions, and the HRQOL summary scores were examined using logistic and linear regression after controlling for significant sociodemographic factors. Results: The lifetime prevalence of DSM-IV AUD was 4.6% (0.5% for dependence and 4.1% for abuse) in the adult population, while the lifetime prevalence of DSM-5 AUD was 2.2%. Younger age, male gender, and lower education were associated with higher odds of both DSM-IV and DSM-5 AUD. However, those who were economically inactive (versus employed) (AOR, 0.4; 95% CI 0.2–0.9) and had a higher monthly household income (SGD 4000–5999 versus below SGD 2000) had lower odds of DSM-IV AUD (AOR, 0.4; 95% CI 0.2–0.7), but this was not observed among those with DSM-5 AUD. Both DSM-IV and DSM-5 AUD were associated with significant comorbidities in terms of other mental disorders; however, those diagnosed with lifetime GAD had significantly higher odds of having DSM-5 AUD (AOR, 5; 95% CI 1.9–13.2) but not DSM-IV AUD. Conclusions: While using the DSM-5 criteria would result in a lower prevalence of AUD in Singapore, it remains a highly comorbid condition associated with a poor health-related quality of life that is largely untreated, which makes it a significant public health concern.

Suggested Citation

  • Mythily Subramaniam & Edimansyah Abdin & Alexander Man Cher Kong & Janhavi Ajit Vaingankar & Anitha Jeyagurunathan & Saleha Shafie & Rajeswari Sambasivam & Daniel Shuen Sheng Fung & Swapna Verma & Sio, 2022. "Differences in the Prevalence and Profile of DSM-IV and DSM-5 Alcohol Use Disorders—Results from the Singapore Mental Health Study 2016," IJERPH, MDPI, vol. 20(1), pages 1-12, December.
  • Handle: RePEc:gam:jijerp:v:20:y:2022:i:1:p:285-:d:1013817
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    1. repec:cup:judgdm:v:1:y:2006:i::p:48-63 is not listed on IDEAS
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