Miele G M, Tilly S M, First M, Frances A
American Psychiatric Association, Washington, DC 20005.
Br J Addict. 1990 Nov;85(11):1421-3; discussion 1429-31. doi: 10.1111/j.1360-0443.1990.tb01623.x.
DSM-III-R and ICD-10 have incorporated a much broader definition of chemical dependence than was included in DSM-III. This broader definition no longer requires the presence of tolerance and withdrawal, and places greater emphasis on aspects of compulsive use. Using this broader definition, a number of behavioral syndromes, especially compulsive and impulse disorders, appear to share descriptive similarities with chemical dependence. Although these similarities in overt presentation may reflect underlying similarities in pathogenesis and treatment response, such a non-specific definition may also obscure important differences. Given the available knowledge, it is unclear if it is more useful to highlight the similarities among chemical dependencies and other behavioral syndromes or to maintain their distinction.
