A COMPARISON OF DSM-III-R AND ICD-10 PERSONALITY-DISORDER CRITERIA INAN OUTPATIENT POPULATION

This study reports the results of a comparison of DSM-III-R and ICD-10 personality disorder criteria by application of both sets of criteria to the same group of patients. Despite the clinical relevance of thes e disorders and the need for reliable diagnostic criteria, such a comp arison has not previously been reported. DSM-III-R and ICD-10 have con verged in their classification of personality disorders, but some impo rtant differences between the two systems remain. Personality disorder diagnoses from both systems were obtained in 52 out-patients, using t he Standardized Assessment of Personality (SAP), a brief, informant-ba sed interview which yields diagnoses in both DSM-III-R and ICD-10. For individual personality disorder diagnoses, agreement between systems was limited. Thirty-four subjects received a personality disorder diag nosis that had an equivalent form in both systems, but only 10 subject s (29%) received the same primary diagnosis in each system. There was a difference in rate of diagnosis, with ICD-10 making significantly mo re personality disorder diagnoses. The lower diagnostic threshold of t he ICD-10 contributed most of this effect. Further modifications in IC D-10 Diagnostic Criteria for Research (DCR) and DSM-IV to the personal ity disorder category have been considered. The omission in DSM-IV of three categories unique to that system and the raising of the threshol d in ICD-10 DCR, do seem to have been helpful in promoting convergence .