Cottler L B, Helzer J E, Mager D, Spitznagel E L, Compton W M
Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110.
Drug Alcohol Depend. 1991 Dec;29(1):17-25. doi: 10.1016/0376-8716(91)90018-t.
With proposed criteria for DSM-IV substance dependence imminent, an evaluation of the impact of changes from DSM-III to DSM-III-R would be informative. Recent admissions to St. Louis drug treatment centers were interviewed with the DIS-III-R, which covers criteria from both systems. Kappa values for system agreement, diagnostic overlap and percent positive agreement are reported by substance. The DSM-III-R system cast a wider net for dependence than DSM-III for alcohol, tobacco and amphetamines. Neither system predominated for cannabis, opioids and barbiturates/sedatives/hypnotics. Reasons for differences and implications of findings are discussed.
随着即将出台的《精神疾病诊断与统计手册》第四版（DSM-IV）物质依赖标准，评估从《精神疾病诊断与统计手册》第三版（DSM-III）到第三版修订本（DSM-III-R）的变化影响将很有意义。对近期入住圣路易斯戒毒治疗中心的患者进行了使用诊断访谈表第三版修订本（DIS-III-R）的访谈，该访谈表涵盖了两个版本的标准。按物质类别报告了系统一致性、诊断重叠和阳性一致率的卡帕值。对于酒精、烟草和苯丙胺，DSM-III-R系统比DSM-III对依赖的界定范围更广。对于大麻、阿片类药物和巴比妥类/镇静剂/催眠药，两个系统均未占主导地位。讨论了差异的原因及研究结果的意义。
