NARROWING OF THE DRINKING REPERTOIRE CRITERION - SHOULD IT HAVE BEEN DROPPED FROM ICD-10

Objective: To present data on the reliability of the narrowing of the drinking repertoire criterion in the ICD-10 substance use disorder nom enclature and possible justification for its exclusion from ICD-10. Th is criterion has been one of the hallmarks of the Edwards and Gross de pendence concept. Method: The sample of 318 consisted of 175 substance users from St. Louis areas substance abuse treatment programs and 143 substance users from the St. Louis Epidemiologic Catchment Area Proje ct, a general population survey. Respondents were interviewed about th eir substance use with the CIDI-SAM and reinterviewed approximately 1 week later. ''Narrowing of the drinking repertoire'' was reported by 2 4%. Results: Overall, the agreement from interview 1 to interview 2 wa s fair to good (kappa = 0.5851). Men and drinkers in treatment were fo und to be more reliable reporters than women and drinkers recruited fr om the general population. Conclusions: The decision to drop the reper toire criterion seems justified, especially when nonclinical samples a re interviewed. However, since our data found it highly associated wit h meeting criteria for a dependence disorder it is clinically valid. A dditional research among varied populations is necessary to determine if the concept of narrowing is culture or gender specific and if its d eletion affects rates of dependence.