A COMPARISON OF ICD-10 AND DSM-III-R CRITERIA FOR SUBSTANCE-ABUSE ANDDEPENDENCE

As part of DSM-IV field trials for substance use disorders, 100 inpati ents from two psychiatric substance abuse units were interviewed using a modified version of the Substance Abuse Module (SAM) to ascertain s ubstance use diagnoses according to ICD-10 and DSM-III-R criteria. Bot h criteria sets developed from the theoretical framework presented by Gross and Edwards (1976) and thus, they should demonstrate close concu rrence in diagnoses of dependence and abuse/harmful use. The kappa sco res obtained in these analyses demonstrate good to excellent agreement on the diagnoses of dependence across substances. There was poor agre ement between DSM-III-R and ICD-10 for abuse/harmful use diagnoses. Al though there is generally good agreement between DSM-III-R and ICD-10 for substance dependence diagnoses, important differences exist betwee n the two criteria sets both for the diagnoses of abuse and harmful us e, and for the diagnosis of marijuana dependence. These differences ar e primarily due to the inclusion of social problems and repeated use o f substances in hazardous situations as DSM-III-R criteria.