Diagnostic Reliability and Validity of the Semi-Structured Assessment for Drug Dependence and Alcoholism (SSADDA) Chinese Version

Relationships Between Impulsivity, Methamphetamine use Disorder and Gambling Disorder

Methamphetamine use disorder (MAUD) and gambling disorder (GD) frequently co-occur. Individuals with both conditions are typically more difficult to treat than those with either disorder alone. This study aimed to investigate the co-occurrence and clinical characteristics of people with MAUD and GD. Between March 2018 and August 2020, 350 men with methamphetamine use entering a compulsory drug rehabilitation center in Changsha, Hunan Province received semi-structured interviews. Participants completed the Barratt Impulsiveness Scale-11 and provided information on childhood upbringings and drug use characteristics. Independent sample t-tests compared differences between individuals with MAUD and with and without co-occurring GD. Dichotomous logistic regression was used to statistically predict co-occurring GD. The prevalence of GD was 45.1%. Most individuals (39.1% overall) had post-onset methamphetamine use (PoMAU-GD). The number of MAUD symptoms, history of gambling by family members, age of first sexual activity, and non-planning impulsivity statistically predicted PoMAU-GD, jointly explaining 24.0% of the total variance. The regression model fit well (HLχ2 = 5.503, p = 0.70), in which the specificity was 0.80, the sensitivity was 0.64, and the area under the curve was 0.79 (95%CI: 0.75-0.84). This study clarifies the prevalence of and potential risk factors for GD among individuals engaging in compulsory MAUD treatment in China. The high prevalence and associated clinical features of GD in the MAUD group highlight the importance of screening for GD in this population and intervening accordingly.

Reliability and validity of DSM-IV and DSM-5 methamphetamine use disorder diagnoses using the Chinese Version of the Semi-Structured Assessment for Drug Dependence and Alcoholism (SSADDA)

BACKGROUND

The Semi-structured Assessment for Drug Dependence and Alcoholism (SSADDA) was developed to assess substance-use disorders and other psychiatric traits. We translated the SSADDA into Chinese and evaluated its inter-rater reliability and concurrent validity in diagnosing DSM-IV methamphetamine (MA) dependence and DSM-5 MA-use disorder (MUD).

METHODS

The sample comprised 231 participants who were interviewed using the Chinese SSADDA and the Mini-International Neuropsychiatric Interview (Chinese MINI) for concurrent validation. Of the 231 participants, 191 were interviewed by two different interviewers two weeks apart. We evaluated the inter-rater reliability and concurrent validity of the diagnoses using percent agreement and Cohen's kappa coefficient (κ). Cohen's linear weighted kappa was used to assess the reliability of DSM-5 MUD severity.

RESULTS

It showed good inter-rater reliability and no significant differences among the DSM-5 MUD (κ = 0.71), DSM-IV MA abuse or dependence (κ = 0.72), and the DSM-IV diagnoses of MA dependence (κ = 0.66) and abuse (κ = 0.68) tested separately. The weighted kappa was 0.67 across the three DSM-5 MUD severity levels. The reliability of each individual diagnostic criterion for DSM-5 MUD ranged from fair to excellent (κ = 0.41-0.80), except for "repeated attempts to quit/control use" (κ = 0.38). The concurrent validity based on MINI-derived diagnoses ranged from good to excellent (κ = 0.65-0.78).

CONCLUSIONS

This study shows that the Chinese version of SSADDA has good reliability and validity among Chinese MA users.