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Article
A systematic review of the Diagnostic and Statistical Manual diagnostic criteria for nicotine dependence
Psychiatry Publications and Presentations
  • Joseph R. DiFranza, University of Massachusetts Medical School
  • W. W. Sanouri A. Ursprung, University of Massachusetts Medical School
  • Beatrice Lauzon, Université de Montréal
  • Christina Bancej, Public Health Agency of Canada
  • Robert J. Wellman, University of Massachusetts Medical School
  • Douglas M. Ziedonis, University of Massachusetts Medical School
  • Sun S. Kim, University of Massachusetts Medical School
  • Andre Gervais, Direction de santé publique de Montréal, Quebec
  • Bruce Meltzer, University of Massachusetts Medical School
  • Colleen E. McKay, University of Massachusetts Medical School
  • Jennifer O'Loughlin, University of Montreal
  • Chizimuzo T. C. Okoli, University of British Columbia
  • Lisa R. Fortuna, University of Massachusetts Medical School
  • Michele Tremblay, Médecin Conseil Institut National de Santé Publique du Québec
UMMS Affiliation
Department of Family Medicine and Community Health; Department of Psychiatry
Publication Date
1-9-2010
Document Type
Article
Disciplines
Abstract

The Diagnostic and Statistical Manual diagnostic criteria for nicotine dependence (DSM-ND) are based on the proposition that dependence is a syndrome that can be diagnosed only when a minimum of 3 of the 7 proscribed features are present. The DSM-ND criteria are an accepted research measure, but the validity of these criteria has not been subjected to a systematic evaluation. To systematically review evidence of validity and reliability for the DSM-ND criteria, a literature search was conducted of 16 national and international databases. Each article with original data was independently reviewed by two or more reviewers. In total, 380 potentially relevant articles were examined and 169 were reviewed in depth. The DSM-ND criteria have seen wide use in research settings, but sensitivity and specificity are well below the accepted standards for clinical applications. Predictive validity is generally poor. The 7 DSM-ND criteria are regarded as having face validity, but no data support a 3-symptom ND diagnostic threshold, or a 4-symptom withdrawal syndrome threshold. The DSM incorrectly states that daily smoking is a prerequisite for withdrawal symptoms. The DSM shows poor to modest concurrence with all other measures of nicotine dependence, smoking behaviors and biological measures of tobacco use. The data support the DSM-ND criteria as a valid measure of nicotine dependence severity for research applications. However, the data do not support the central premise of a 3-symptom diagnostic threshold, and no data establish that the DSM-ND criteria provide an accurate diagnosis of nicotine dependence.

DOI of Published Version
10.1016/j.addbeh.2009.12.013
Source
Addict Behav. 2010 May;35(5):373-82. Epub 2009 Dec 21. Link to article on publisher's site
Related Resources
Link to Article in PubMed
PubMed ID
20056335
Citation Information
Joseph R. DiFranza, W. W. Sanouri A. Ursprung, Beatrice Lauzon, Christina Bancej, et al.. "A systematic review of the Diagnostic and Statistical Manual diagnostic criteria for nicotine dependence" Vol. 35 Iss. 5 (2010) ISSN: 0306-4603 (Linking)
Available at: http://works.bepress.com/colleen_mckay/11/