Summary
Diagnoses of alcohol dependence, using the classification systems ICD-9 and DSM-III-R, were compared in a sample of 215 psychiatric outpatients. A lower diagnostic threshold was obtained for DSM-III-R. This category tended to be more inclusive for relatively mild forms of inadequate alcohol use. Of those patients with ICD-9 alcohol dependence, 79% also met criteria for the corresponding DSM-III-R category, whereas 61% of subjects diagnosed as dependent according to DSM-III-R received the equivalent diagnosis in ICD-9. These results were obtained assuming equal base rates (sample frequencies) for dependence and abuse. Diagnoses were further compared with independently derived scores of the Munich Alcoholism Test (MALT), and the validity of DSM-III-R was found to be superior. Checklist-guided interviews had a positive impact upon accuracy and validity of diagnoses.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
American Psychiatric Association (APA) (1987) Diagnostic and statistical manual of mental disorders DSM-III-R. APA, Washington. German edition: Wittchen H-U, Saß H, Zaudig M, Köhler K (1989) Diagnostisches und Statistisches Manual Psychischer Störungen DSM-III-R. Beltz, Weinheim
Auerbach P, Melchertsen K (1981) Zur Häufigkeit des Alkoholismus stationär behandelter Patienten. Schlesw Holst Ärztebl 5:223–227
Babor TF, Kranzler HR, Kadden RM (1986) Issues in the definition and diagnosis of alcoholism: implications for a reformulation. Prog Neuropsychopharmacol Biol Psychiatry 10:113–128
Caetano R (1985) Two versions of dependence: DSM-III and the alcohol dependence syndrome. Drug Alcohol Depend 15:81–103
Cohen J (1960) A coefficient of agreement for nominal scales. Educ Psychol Meas 20:37–46
Edwards G (1986) The alcohol dependence syndrome: a concept as stimulus to enquiry. Br J Addict 81:171–183
Edwards G, Gross MM, Keller M, Moser J, Room R (1977) Alcohol-related disabilities. WHO, Geneva, Offset Publication No. 32
Feuerlein W (1987) Definition und Diagnose der Suchtkrankheiten. In: Kisker KP, Lauter H, Meyer J-E, Müller C, Strömgren E (eds) Psychiatrie der Gegenwart 3, Abhängigkeit und Sucht, 3rd edn. Springer, Berlin Heidelberg New York
Feuerlein W, Ringer C, Küfner H, Antons K (1977) Diagnose des Alkoholismus. Der Münchner Alkoholismustest (MALT). Münch Med Wochenschr 119:1275–1282
Feuerlein W, Küfner H, Ringer C, Antons K (1979) Münchner Alkoholismustest (Manual). Beltz, Weinheim
Feuerlein W, Ringer C, Küfner H, Antons K (1980) Diagnosis of alcoholism: the Munich Alcoholism Test (MALT). In: Galanter M (ed) Currents in alcoholism, volume VII. Grune and Stratton, New York
Fleiss JL (1981) Statistical methods for rates and proportions, 2nd edn. Wiley, New York
Helzer JE, Robins LN, Taibleson M, Woodruff RA, Reich T, Wish ED (1977) Reliability of psychiatric diagnoses. I. A methodological review. Arch Gen Psychiatry 34:129–133
Hiller W, Zaudig M, Mittelhammer J (1987) Münchner Diagnosen-Checkliste (MDCL) zur Erfassung des psychischen und psychopathologischen Befundes. Max-Planck-Institut für Psychiatrie, Psychiatrische Poliklinik, München
Hiller W, Mombour W, Rummler R, Mittelhammer J (1988) Divergence and convergence of diagnoses for depression between ICD-9 and DSM-III-R. Eur Arch Psychiatr Neurol Sci 238:39–46
Hiller W, Zaudig M, Bose M von, Rummler R (1989) Anxiety disorders: a comparison of the ICD-9 and DSM-III-R classification systems. Acta Psychiatr Scand 79:338–347
Robins LN (1982) The diagnosis of alcoholism after DSM-III. In: Pattison EM, Kaufman E (eds) Encyclopedic handbook of alcoholism. Gardner Press, New York
Rounsaville BJ (1987) Substance use disorders. In: Skodol AE, Spitzer RL (ed) An annotated bibiography of DSM-III. American Psychiatric Press, Washington, DC
Rounsaville BJ, Spitzer RL, Williams JBW (1986) Proposed changes in DSM-III substance use disorders: description and rationale. Am J Psychiatry 143:463–468
Semler G, Wittchen H-U, Joschke K, Zaudig M, Geiso T von, Kaiser S, Cranach M von, Pfister H (1987) Test-retest reliability of a standardized psychiatric interview (DIS/CIDI). Eur Arch Psychiatr Neurol Sci 236:214–222
Skinner HA, Allen BA (1982) Alcohol dependence syndrome: measurement and validation. J Abnorm Psychol 91:199–209
Skinner HA, Holt S, Israel Y (1981) Early identification of alcohol abuse. 1. critical issues and psychosocial indicators for a composite index. Can Med Assoc J 124:1141–1152
Skodol AE, Spitzer RL (1982) DSM-III: rationale, basic concepts, and some differences from ICD-9. Acta Psychiatr Scand 66:271–281
Spitzer RL, Endicott J, Robins E (1978) Reliability of clinical criteria for psychiatric diagnosis. In: Akiskal HS, Webb WL (eds) Psychiatric diagnosis: exploration of biological predictors. Spectrum Publications, Jamaica
Spitzer RL, Forman J, Nee J (1979) DSM-III field trials: initial interrater diagnostic reliability. Am J Psychiatry 136:815–820
Wittchen H-U, Schulte D (1988) Diagnostische Kriterien und operationalisierte Diagnosen. Grundlagen der Klassifikation psychischer Störungen. Diagnostica 34:3–27
World Health Organisation (WHO) Mental disorders: glossary and guide to their classification in accordance with the ninth revision of the International Classification of Diseases. WHO, Geneva. German edition: Degkwitz R, Helmchen H, Kockott G, Mombour W (1980) Diagnoseschlüssel und Glossar psychiatrischer Krankheiten. Deutsche Ausgabe der internationalen Klassifikation der Krankheiten der WHO, ICD, 9. Revision. Springer, Berlin Heidelberg New York
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Hiller, W. Alcohol dependence in ICD-9 and DSM-III-R: A comparative polydiagnostic study. Eur Arch Psychiatr Neurol Sci 239, 101–108 (1989). https://doi.org/10.1007/BF01759582
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF01759582