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Determining the diagnostic cut-off on the Chinese version of severity of dependence scale for DSM-5 stimulant use
Albert Kar Kin Chung1, Welton Leung1, Cheuk Yin Tse1
1Department of Psychiatry, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.
Objective:
To investigate the psychometric properties of the Chinese version of the Severity of Dependence Scale for stimulant (C-SDS-S) in screening for the DSM-5-defined Stimulant Use Disorder (SUD).
Design:
Retrospective chart review.
Methods:
A total of 227 Chinese-speaking stimulant (methamphetamine and cocaine) users were identified from four previous studies conducted in Hong Kong. Their demographic data, frequency of stimulant use within the past 30 days, scorings for C-SDS-S and the severity of SUD at baseline were extracted and synthesized. In addition, test-retest reliability of C-SDS-S was assessed in 101 subjects who reported C-SDS-S scorings 4 weeks after baseline.
Findings:
The C-SDS-S demonstrated an acceptable internal consistency with a Cronbach's alpha of 0.736. C-SDS-S scorings were associated with the severity of SUD (ρ = 0.292, p <.001) and with the frequency of stimulant use within the past 30 days (ρ = 0.196, p = .003). All items loaded into one factor which accounted for 50.21% of the variance. Receiver operating characteristic analysis demonstrated that a C-SDS-S cut-off score of ≥ 5 provided optimal discrimination for moderate-to-severe SUD among Chinese-speaking individuals using stimulants. Total scores and individual items of the C-SDS-S demonstrated fair to moderate 30-day test-retest reliability (intraclass correlation coefficient = 0.49; weighted Kappa's = 0.25-0.46).
Conclusion:
The C-SDS-S is a valid and reliable screening instrument to identify stimulant users with DSM-5 defined moderate-to-severe SUD in the Chinese-speaking population.
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