The utility of DSM‐IV criteria in diagnosing substance abuse/dependence in adolescents

Abstract

The purpose of this study was to explore the utility of DSM‐IV criteria in diagnosing alcohol and marijuana abuse/dependence in adolescents. A modified version of the Structured Clinical Interview for DSM‐IV (SCID) was administered to assess substance abuse/dependence symptoms in 127 inpatient, treatment‐seeking adolescents with substance‐use disorders. The proportion of individuals with clinically relevant symptoms was examined separately for individuals classified with either abuse or dependence. Chi‐square tests of independence between the abusive/dependent classification and the presence/absence of a given symptom were also performed. Rates of DSM‐IV current substance use diagnoses were alcohol abuse 21 (16%), alcohol dependence 44 (35%), marijuana abuse 27 (21%) and marijuana dependence 72 (57%). A diagnosis of marijuana dependence was significantly more likely when tolerance symptoms were present but was not significantly dependent on the presence of withdrawal symptoms. By contrast, the presence of both tolerance and withdrawal symptoms were indicative of alcohol dependence. There was a high degree of heterogeneity of DSM‐IV dependence symptoms for both alcohol and marijuana dependence. Our study suggests that the DSM‐IV criteria have limitations in diagnosing substance‐use disorders in adolescents. A modified version of the SCID may be useful in the adolescent substance use population.