Development and Validation of a New Substance Use Disorder Screening Test Based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

Abstract

Objective: The lack of a screening tool for substance use disorders is a significant problem for health care workers for patient care and referral. This study aimed to develop a Substance Use Disorder Screening Test (SUDST) to enable accurate classification of the severity of substance use disorders based on the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), that can be used by health professionals in all settings for basic screening for individuals at risk of substance use disorder. Material and Methods: Following close study of the DSM-5, 11 questions were developed, which were then tested on 207 participants who were receiving treatment for the use of methamphetamines. The participants were interviewed with the SUDST, the Ministry of Public Health Version 2 (normally ‘V.2’) screening test for risk of substance use, and were clinically diagnosed by their attending psychiatrist. Results: The Cronbach’s alpha coefficient for SUDST was 0.79. The scores obtained from the SUDST were in high agreement with the V.2 and clinical diagnosis (p-value<0.001). Factor analysis showed three components of substance use disorder: 1) preoccupation and loss of control, 2) risky/harmful use, and 3) biopsychosocial aspects. Of the total possible score of 11, the cut-off points for identifying severe, moderate, and mild levels of risk were ≥7, 5-6, and 3-4, respectively, with sensitivity=72.7%-96.5% and specificity=61.9%-88.7%. Conclusion: The SUDST had high reliability and validity and could be used to detect patients at risk of substance use disorders.