Spanish journal of psychiatry and mental health · 2025
PRISM-5 update: Adaptation and validation of the Spanish version interview for dual diagnosis assessment based on DSM-5 criteria.
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Tamarit Claudio, Pellicer-Roca Maria, Alias-Ferrí María, Roncero Carlos, Didia-Attas Javier, Fonseca Francina, Mateus Julián Andrés, Mestre Pintó Joan I, Torrens Marta
Аннотация
INTRODUCTION: Diagnosing individuals with co-occurring substance use and other mental disorders (SUDs and MDs) is challenging due to overlapping symptoms and masking effects. Semi-structured interviews, like the Psychiatric Research Interview for Substance and Mental Disorders (PRISM), are essential for diagnostic accuracy. This study aims to update and validate the Spanish PRISM-IV to DSM-5 criteria, providing evidence of reliability based on its ability to assess Dual Disorders (DDs).
MATERIAL AND METHODS: The PRISM-5 was translated and culturally adapted to Spanish to ensure equivalence with the original English version. The interview was computerized using BLAISE© software and pilot-tested. A cross-sectional study with patients recruited from specialized treatment centers in Spain and Argentina compared PRISM-5 diagnoses to those established through the Longitudinal, Expert, All Data (LEAD) method, providing evidence of diagnostic agreement through Cohen's kappa coefficient.
RESULTS: 197 patients were recruited (69% male, mean age=35.6). PRISM-5 showed substantial evidence of diagnostic agreement for most SUDs (k=0.62-0.77), including alcohol, cannabis, cocaine, heroin, sedative, and amphetamine use disorders, with excellent agreement for past heroin use disorder (k=0.83). For MDs, substantial agreement was found for major depression, ADHD and psychotic, panic, and personality disorders (k=0.63-0.73), while moderate agreement was observed for substance-induced and persistent depression (k=0.59-0.60).
CONCLUSIONS: PRISM-5 provided strong evidence of diagnostic reliability in its Spanish version, with substantial agreement across most diagnoses. Compared to the PRISM-IV, it showed similar evidence of reliability, with some notable improvements in areas such as alcohol and cannabis use disorders. These findings underscore the instrument's robustness and value for diagnosing DDs.
MATERIAL AND METHODS: The PRISM-5 was translated and culturally adapted to Spanish to ensure equivalence with the original English version. The interview was computerized using BLAISE© software and pilot-tested. A cross-sectional study with patients recruited from specialized treatment centers in Spain and Argentina compared PRISM-5 diagnoses to those established through the Longitudinal, Expert, All Data (LEAD) method, providing evidence of diagnostic agreement through Cohen's kappa coefficient.
RESULTS: 197 patients were recruited (69% male, mean age=35.6). PRISM-5 showed substantial evidence of diagnostic agreement for most SUDs (k=0.62-0.77), including alcohol, cannabis, cocaine, heroin, sedative, and amphetamine use disorders, with excellent agreement for past heroin use disorder (k=0.83). For MDs, substantial agreement was found for major depression, ADHD and psychotic, panic, and personality disorders (k=0.63-0.73), while moderate agreement was observed for substance-induced and persistent depression (k=0.59-0.60).
CONCLUSIONS: PRISM-5 provided strong evidence of diagnostic reliability in its Spanish version, with substantial agreement across most diagnoses. Compared to the PRISM-IV, it showed similar evidence of reliability, with some notable improvements in areas such as alcohol and cannabis use disorders. These findings underscore the instrument's robustness and value for diagnosing DDs.