한국 과음기준의 DSM-5 알코올 사용 장애에 대한 진단적 유용성
Diagnostic Usefulness of KoreanStandard on Heavy Drinking for the DSM-5 Alcohol Use Disorder
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초록
연구배경: 본 연구는 한국인의 적절음주량 가이드라인 과음기준의 DSM-5 알코올 사용 장애 진단에 대한 진단적 유용성을 조사하였다. 방법:2015년 상반기에 대전의 일개 2차 병원에 속한 건강검진센터에 내원한 976명의 성인들을 대상으로 하였다. 주당 음주횟수와 1일 평균 음주량을 파악 후 주당 음주량을계산하였다. 65세 미만 남성군에서 8잔 초과, 여성 및 65세이상 남성군에서 4잔 초과로 설정되어 있는 한국 과음기준을 사용하여 성별, 연령별로 적절 음주군과 과음군으로 분류하였다. DSM-5 알코올 사용 장애 진단에 대한 한국 과음기준의 민감도, 특이도, 양성예측도, 음성예측도, 양성우도비, 음성우도비, 교차비, Youden's Index를 계산하였다. 결과: 주당음 주량을 통한 DSM-5 알코올 사용 장애 진단모형에 대한 ROC curve의 곡선 아래 면적은 65세 미만 남성군에서 0.812였고 여성 및 65세 이상 남성군에서 0.931이었다. 한국 과음기준의 DSM-5 알코올 사용 장애 진단에 대한 민감도, 특이도, 양성예측도, 음성예측도는 각각 61.0%, 89.7%, 67.0%, 87.05%였으며 양성우도비, 음성우도비, 교차비, Youden's Index는 각각 5.917 (4.704-7.435), 0.434 (0.379-0.497), 13.623 (9.607-19.317), 0.507이었다. 결론: 본 연구결과 한국인의 DSM-5 알코올 사용 장애 진단에 대한 한국 과음기준의 유용성을 확인할 수 있었다.
Abstract
Background:This research investigated the usefulness of heavy drinking standards of 'guidelines for moderate alcohol drinking amount for Koreans' for diagnosis of Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) alcohol use disorder. Methods:This retrospective study was conducted with 976 adults who visited an health screening center in Daejeon for health check-up in 2015. Daily drinking amount, drinking frequency per week, and weekly drinking amount were investigated. Using the heavy drinking criteria of Korean guideline, participants were grouped by age and gender and classified as normal or heavy drinkers. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), Positive likelihood ratio (LR+), Negative likelihood ratio (LR-), odds ratio (OR) and Youden's Index of heavy drinking according to Korean guideline for diagnosis of DSM-5 alcohol use disorder were calculated. Results:The Area under the receiver operating characteristic (ROC) curve of a model screening DSM-5 alcohol use disorder by weekly drinking amount were 0.812 in males up to age 65 years and 0.931 in males over age 65 years and females respectively. The sensitivity, specificity, PPV and NPV of Korean guideline heavy drinking group for diagnosis of DSM-5 alcohol use disorder were 61.0%, 89.7%, 67.0%, and 87.05% respectively. The LR+, LR-, OR and Youden's Index of those were 5.917 (4.704-7.435), 0.434 (0.379-0.497), 13.623 (9.607-19.317), and 0.507 respectively. Conclusions:This research shows the Korean heavy drinking standard is useful for diagnosis of DSM-5 alcohol use disorder in Korean people.
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