Reliability of DSM-IV diagnostic criteria using the Semi-Structured Assessment for Drug Dependence and Alcoholism (SSADDA)

Alcohol Research Center, Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT 06030-2103, United States.
Drug and Alcohol Dependence (Impact Factor: 3.42). 12/2007; 91(1):85-90. DOI: 10.1016/j.drugalcdep.2007.04.014
Source: PubMed


The semi-structured assessment for drug dependence and alcoholism (SSADDA) yields reliable DSM-IV diagnoses for a variety of psychiatric disorders, including alcohol and drug dependence. This study examines the reliability of individual DSM-IV criteria for lifetime substance dependence diagnoses and the impact of those criteria on diagnostic reliability.
Two hundred ninety-three subjects (52.2% women; 38.2% African American, 46.8% European American, 7.5% Hispanic) were interviewed twice over a 2-week period to examine the inter-rater reliability (n=173) or test-retest reliability (n=120) of the SSADDA. Cohen's kappa-statistic and its confidence interval were used to assess the reliability of individual diagnostic criteria.
Overall, the inter-rater reliability estimates were excellent for individual DSM-IV criteria for nicotine and opioid dependence; good for alcohol and cocaine dependence, and fair for dependence on cannabis, sedatives and stimulants. The impact of any individual criterion on diagnostic reliability was minimal, consistent with the notion that the DSM-IV diagnosis of substance dependence measures an underlying construct that is relatively consistent across specific groups of substances.
These results, combined with results from a study of the SSADDA's diagnostic reliability [Pierucci-Lagha, A., Gelernter, J., Feinn, R., Cubells, J.F., Pearson, D., Pollastri, A., Farrer, L., Kranzler, H.R., 2005. Diagnostic reliability of the semi-structured assessment for drug dependence and alcoholism (SSADDA). Drug Alcohol Depend. 80, 303-312], show that the instrument can be used reliably to assess substance dependence.

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Available from: Albert J Arias, Feb 12, 2014
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    • ") for all major psychiatric traits, including opioid, cocaine, or alcohol dependence. Subjects were interviewed using the Semi-Structured Assessment for Drug Dependence and Alcoholism (SSAD- DA) (Gelernter et al, 2005; Pierucci-Lagha et al, 2007). Control subjects had no diagnosed substance use or major psychiatric disorders. "
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    ABSTRACT: Single nucleotide polymorphisms that have been associated with opioid dependence (OD) altogether account for only a small proportion of the known heritability. Most of the genetic risk factors are unknown. Some of the "missing heritability" might be explained by copy number variations (CNVs) in the human genome. We used Illumina HumanOmni1 arrays to genotype 5,152 African-American and European-American OD cases and screened controls and implemented combined CNV calling methods. After quality control measures were applied, a genomewide association study (GWAS) of CNVs with OD was performed. For common CNVs, two deletions and one duplication were significantly associated with OD genomewide (e.g., P=2 × 10(-8) and OR (95% CI)=0.64 (0.54-0.74) for a chromosome 18q12.3 deletion). Several rare or unique CNVs showed suggestive or marginal significance with large effect sizes. This study is the first GWAS of OD using CNVs. Some identified CNVs harbor genes newly identified here to be of biological importance in addiction, while others affect genes previously known to contribute to substance dependence risk. Our findings augment our specific knowledge of the importance of genomic variation in addictive disorders, and provide an addiction CNV pool for further research. These findings require replication.Neuropsychopharmacology accepted article preview online, 27 October 2014. doi:10.1038/npp.2014.290.
    Full-text · Article · Oct 2014 · Neuropsychopharmacology: official publication of the American College of Neuropsychopharmacology
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    • "All subjects gave written, informed consent to participate, using procedures approved by the institutional review board at each participating site. Subjects were phenotyped using a computer-assisted interview, called the Semi-Structured Assessment for Drug Dependence and Alcoholism (SSADDA) [19], a polydiagnostic instrument that was used to generate diagnoses of dependence on cocaine and other substances. Sixty-four yes-or-no variables were generated by this survey, which were also used in previous genetic association studies [1,20,21]. "
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    ABSTRACT: Background Accurate classification of patients with a complex disease into subtypes has important implications for medicine and healthcare. Using more homogeneous disease subtypes in genetic association analysis will facilitate the detection of new genetic variants that are not detectible using the non-differentiated disease phenotype. Subtype differentiation can also improve diagnostic classification, which can in turn inform clinical decision making and treatment matching. Currently, the most sophisticated methods for disease subtyping perform cluster analysis using patients’ clinical features. Without guidance from genetic information, the resultant subtypes are likely to be suboptimal and efforts at genetic association may fail. Results We propose a multi-view matrix decomposition approach that integrates clinical features with genetic markers to detect confirmatory evidence for a disease subtype. This approach groups patients into clusters that are consistent between the clinical and genetic dimensions of data; it simultaneously identifies the clinical features that define the subtype and the genotypes associated with the subtype. A simulation study validated the proposed approach, showing that it identified hypothesized subtypes and associated features. In comparison to the latest biclustering and multi-view data analytics using real-life disease data, the proposed approach identified clinical subtypes of a disease that differed from each other more significantly in the genetic markers, thus demonstrating the superior performance of the proposed approach. Conclusions The proposed algorithm is an effective and superior alternative to the disease subtyping methods employed to date. Integration of phenotypic features with genetic markers in the subtyping analysis is a promising approach to identify concurrently disease subtypes and their genetic associations.
    Full-text · Article · Jun 2014 · BMC Genetics
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    • "All subjects were assessed with the Semi-Structured Assessment for Drug Dependence and Alcoholism (SSADDA) [52], [53], which yields a DSM-IV based lifetime diagnoses for a variety of psychiatric and substance use disorders. Individuals with a primary diagnosis of bipolar affective disorder or schizophrenia were excluded. "
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    ABSTRACT: Personality correlates highly with both cocaine and nicotine dependencies (CD, ND), and their co-morbid psychopathologies. However, little is known about the nature of these relationships. This study examined if environment (marriage) or genetics (a single SNP, CHRNA5*rs16969968) would moderate the correlation of personality with CD, ND and cocaine-induced paranoia (CIP) in African and European Americans (AAs, EAs). 1432 EAs and 1513 AAs were examined using logistic regression. Personality was assessed by NEO-PI-R, while CD, ND and CIP were diagnosed according to DSM-IV. ND and CD were examined as binary traits and for the analysis of CIP, subjects were divided into 3 groups: (A) Controls with no CIP; (B) CD cases without CIP; and (C) CD cases with CIP. Multiple testing was Bonferroni-corrected. For CD and ND in the EA population, marital status proved to be a significant moderator in their relationship with openness only (OR = 1.90, 95%CI = 1.36-2.64, p = 1.54e-04 and OR = 2.12, 95%CI = 1.52-2.90, p = 4.65e-06 respectively). For CIP, marriage was observed to moderate its correlation with openness and neuroticism (OR = 1.39, 95%CI = 1.18-1.63, p = 7.64e-04 and OR = 1.26, 95%CI = 1.12-1.42, p = 1.27e-03 respectively). The correlations moderated by rs16969968 were those of conscientiousness and CD (OR = 1.62, 95%CI: 1.23-2.12, p = 8.94e-04) as well as CIP (OR = 1.21, 95%CI: 1.11-1.32, p = 4.93e-04 when comparing group A versus group C). No significant interactions were observed in AA population. The Bonferroni-corrected significance threshold was set to be 1.67e-03. The role of personality in CD and CIP may be interceded by both environment and genetics, while in ND by environment only.
    Full-text · Article · Jan 2013 · PLoS ONE
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