Long-term stability of alcohol and other substance dependence diagnoses and habitual smoking: An evaluation after 5 years

Robert Culverhouse, Kathleen K. Bucholz, Raymond R. Crowe, Victor Hesselbrock, John Nurnberger, Bernice Porjesz, Marc A. Schuckit, Theodore Reich, Laura Jean Bierut

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Context: A major criterion to validate diagnoses is stability over time. Objective: To examine the stability of several classification systems for lifetime diagnosis of alcohol dependence, to identify characteristics predicting stability of alcoholism, and to study stability of lifetime assessments of habitual smoking (1 pack per day for at least 6 months) and other drug dependence. Design: Participants in the Collaborative Study on the Genetics of Alcoholism were interviewed using the Semi-Structured Assessment for the Genetics of Alcoholism and reevaluated 5 years later. Initial and follow-up interviews were available for 1728 individuals (641 index cases, 800 siblings, 287 controls) with lifetime diagnoses of alcohol dependence, other substance dependence (marijuana, cocaine, other stimulants, sedatives, opioids), or habitual smoking at first interview. The likelihood that an individual with a lifetime history of substance dependence or habitual smoking at the first interview retained this classification after 5 years was examined to assess stability of diagnosis. Results: Stability of a lifetime diagnosis of alcohol dependence varied among the subject groups of index cases, siblings, and community-based controls. Alcohol dependence as defined by DSM-III-R criteria was highly stable in the index cases (90.5% women, 94.7% men) but much less stable in the community-based controls (27.5% women, 64.7% men). The most important characteristic associated with stability of diagnosis of alcohol dependence was severity, defined by the number of alcoholrelated symptoms. Other DSM-III-R substance dependence disorders varied in the stability of diagnosis over a 5-year period. Lifetime history of habitual smoking was highly stable in all subject groups (96.0% overall). Conclusions: Stability of lifetime assessment of alcohol dependence varies depending on severity of illness. Severe cases of alcohol dependence are more likely to be stable, whereas general population cases of alcohol dependence are less likely to have stable diagnoses. The stability of diagnosis for other substance dependence varies from substance to substance.

Original languageEnglish
Pages (from-to)753-760
Number of pages8
JournalArchives of General Psychiatry
Volume62
Issue number7
DOIs
StatePublished - Jul 2005

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Alcoholism
Substance-Related Disorders
Smoking
Alcohols
Interviews
Diagnostic and Statistical Manual of Mental Disorders
Siblings
Cannabis
Hypnotics and Sedatives
Cocaine
Opioid Analgesics

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Long-term stability of alcohol and other substance dependence diagnoses and habitual smoking : An evaluation after 5 years. / Culverhouse, Robert; Bucholz, Kathleen K.; Crowe, Raymond R.; Hesselbrock, Victor; Nurnberger, John; Porjesz, Bernice; Schuckit, Marc A.; Reich, Theodore; Bierut, Laura Jean.

In: Archives of General Psychiatry, Vol. 62, No. 7, 07.2005, p. 753-760.

Research output: Contribution to journalArticle

Culverhouse, R, Bucholz, KK, Crowe, RR, Hesselbrock, V, Nurnberger, J, Porjesz, B, Schuckit, MA, Reich, T & Bierut, LJ 2005, 'Long-term stability of alcohol and other substance dependence diagnoses and habitual smoking: An evaluation after 5 years', Archives of General Psychiatry, vol. 62, no. 7, pp. 753-760. https://doi.org/10.1001/archpsyc.62.7.753
Culverhouse, Robert ; Bucholz, Kathleen K. ; Crowe, Raymond R. ; Hesselbrock, Victor ; Nurnberger, John ; Porjesz, Bernice ; Schuckit, Marc A. ; Reich, Theodore ; Bierut, Laura Jean. / Long-term stability of alcohol and other substance dependence diagnoses and habitual smoking : An evaluation after 5 years. In: Archives of General Psychiatry. 2005 ; Vol. 62, No. 7. pp. 753-760.
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abstract = "Context: A major criterion to validate diagnoses is stability over time. Objective: To examine the stability of several classification systems for lifetime diagnosis of alcohol dependence, to identify characteristics predicting stability of alcoholism, and to study stability of lifetime assessments of habitual smoking (1 pack per day for at least 6 months) and other drug dependence. Design: Participants in the Collaborative Study on the Genetics of Alcoholism were interviewed using the Semi-Structured Assessment for the Genetics of Alcoholism and reevaluated 5 years later. Initial and follow-up interviews were available for 1728 individuals (641 index cases, 800 siblings, 287 controls) with lifetime diagnoses of alcohol dependence, other substance dependence (marijuana, cocaine, other stimulants, sedatives, opioids), or habitual smoking at first interview. The likelihood that an individual with a lifetime history of substance dependence or habitual smoking at the first interview retained this classification after 5 years was examined to assess stability of diagnosis. Results: Stability of a lifetime diagnosis of alcohol dependence varied among the subject groups of index cases, siblings, and community-based controls. Alcohol dependence as defined by DSM-III-R criteria was highly stable in the index cases (90.5{\%} women, 94.7{\%} men) but much less stable in the community-based controls (27.5{\%} women, 64.7{\%} men). The most important characteristic associated with stability of diagnosis of alcohol dependence was severity, defined by the number of alcoholrelated symptoms. Other DSM-III-R substance dependence disorders varied in the stability of diagnosis over a 5-year period. Lifetime history of habitual smoking was highly stable in all subject groups (96.0{\%} overall). Conclusions: Stability of lifetime assessment of alcohol dependence varies depending on severity of illness. Severe cases of alcohol dependence are more likely to be stable, whereas general population cases of alcohol dependence are less likely to have stable diagnoses. The stability of diagnosis for other substance dependence varies from substance to substance.",
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AU - Crowe, Raymond R.

AU - Hesselbrock, Victor

AU - Nurnberger, John

AU - Porjesz, Bernice

AU - Schuckit, Marc A.

AU - Reich, Theodore

AU - Bierut, Laura Jean

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N2 - Context: A major criterion to validate diagnoses is stability over time. Objective: To examine the stability of several classification systems for lifetime diagnosis of alcohol dependence, to identify characteristics predicting stability of alcoholism, and to study stability of lifetime assessments of habitual smoking (1 pack per day for at least 6 months) and other drug dependence. Design: Participants in the Collaborative Study on the Genetics of Alcoholism were interviewed using the Semi-Structured Assessment for the Genetics of Alcoholism and reevaluated 5 years later. Initial and follow-up interviews were available for 1728 individuals (641 index cases, 800 siblings, 287 controls) with lifetime diagnoses of alcohol dependence, other substance dependence (marijuana, cocaine, other stimulants, sedatives, opioids), or habitual smoking at first interview. The likelihood that an individual with a lifetime history of substance dependence or habitual smoking at the first interview retained this classification after 5 years was examined to assess stability of diagnosis. Results: Stability of a lifetime diagnosis of alcohol dependence varied among the subject groups of index cases, siblings, and community-based controls. Alcohol dependence as defined by DSM-III-R criteria was highly stable in the index cases (90.5% women, 94.7% men) but much less stable in the community-based controls (27.5% women, 64.7% men). The most important characteristic associated with stability of diagnosis of alcohol dependence was severity, defined by the number of alcoholrelated symptoms. Other DSM-III-R substance dependence disorders varied in the stability of diagnosis over a 5-year period. Lifetime history of habitual smoking was highly stable in all subject groups (96.0% overall). Conclusions: Stability of lifetime assessment of alcohol dependence varies depending on severity of illness. Severe cases of alcohol dependence are more likely to be stable, whereas general population cases of alcohol dependence are less likely to have stable diagnoses. The stability of diagnosis for other substance dependence varies from substance to substance.

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