Abuse and dependence on prescription opioids in adults: a mixture categorical and dimensional approach to diagnostic classification.

Wu, L-T

Woody, GE

Yang, C

Pan, J-J

Blazer, DG

2020-02-03T05:45:44Z

2020-02-03T05:45:44Z

2011-03

2020-02-03T05:45:44Z

For the emerging DSM-V, it has been recommended that dimensional and categorical methods be used simultaneously in diagnostic classification; however, little is known about this combined approach for abuse and dependence.Using data (n=37 708) from the 2007 National Survey on Drug Use and Health (NSDUH), DSM-IV criteria for prescription opioid abuse and dependence among non-prescribed opioid users (n=3037) were examined using factor analysis (FA), latent class analysis (LCA, categorical), item response theory (IRT, dimensional), and factor mixture (hybrid) approaches.A two-class factor mixture model (FMM) combining features of categorical latent classes and dimensional IRT estimates empirically fitted more parsimoniously to abuse and dependence criteria data than models from FA, LCA and IRT procedures respectively. This mixture model included a severely affected group (7%) with a comparatively moderate to high probability (0.32-0.88) of endorsing all abuse and dependence criteria items, and a less severely affected group (93%) with a low probability (0.003-0.16) of endorsing all criteria. The two empirically defined groups differed significantly in the pattern of non-prescribed opioid use, co-morbid major depression, and substance abuse treatment use.A factor mixture model integrating categorical and dimensional features of classification fits better to DSM-IV criteria for prescription opioid abuse and dependence in adults than a categorical or dimensional approach. Research is needed to examine the utility of this mixture classification for substance use disorders and treatment response.

S0033291710000954

0033-2917

1469-8978

https://hdl.handle.net/10161/19993

eng

Cambridge University Press (CUP)

Psychological medicine

10.1017/S0033291710000954

Humans

Opioid-Related Disorders

Severity of Illness Index

Prevalence

Factor Analysis, Statistical

Logistic Models

Chi-Square Distribution

Diagnostic and Statistical Manual of Mental Disorders

Adolescent

Adult

United States

Female

Male

Prescription Drugs

Young Adult

Abuse and dependence on prescription opioids in adults: a mixture categorical and dimensional approach to diagnostic classification.

Journal article

Wu, L-T|0000-0002-5909-2259

653

664

3

School of Medicine

Duke

Center for Child and Family Policy

Sanford School of Public Policy

Duke Clinical Research Institute

Institutes and Centers

Duke Institute for Brain Sciences

University Institutes and Centers

Institutes and Provost's Academic Units

Psychiatry & Behavioral Sciences, Social and Community Psychiatry

Psychiatry & Behavioral Sciences

Clinical Science Departments

Medicine, General Internal Medicine

Medicine

Center for the Study of Aging and Human Development

Family Medicine and Community Health

Psychiatry & Behavioral Sciences, Geriatric Behavioral Health

Published

41