Proctor Steven L, Williams Daniel C, Kopak Albert M, Voluse Andrew C, Connolly Kevin M, Hoffmann Norman G
Albizu University-Miami Campus, Department of Psychology, USA.
G.V. (Sonny) Montgomery VA Medical Center, Addictive Disorders Treatment Program, USA; University of Mississippi Medical Center, Department of Psychiatry and Human Behavior, USA.
Addict Behav. 2016 Jul;58:117-22. doi: 10.1016/j.addbeh.2016.02.034. Epub 2016 Feb 20.
With the recent federal mandate that all U.S. health care settings transition to ICD-10 billing codes, empirical evidence is necessary to determine if the DSM-5 designations map to their respective ICD-10 diagnostic categories/billing codes. The present study examined the concordance between DSM-5 and ICD-10 cannabis use disorder diagnoses.
Data were derived from routine clinical assessments of 6871 male and 801 female inmates recently admitted to a state prison system from 2000 to 2003. DSM-5 and ICD-10 diagnostic determinations were made from algorithms corresponding to the respective diagnostic formulations.
Past 12-month prevalence rates of cannabis use disorders were comparable across classification systems. The vast majority of inmates with no DSM-5 diagnosis continued to have no diagnosis per the ICD-10, and a similar proportion with a DSM-5 severe diagnosis received an ICD-10 dependence diagnosis. Most of the variation in diagnostic classifications was accounted for by those with a DSM-5 moderate diagnosis in that approximately half of these cases received an ICD-10 dependence diagnosis while the remaining cases received a harmful use diagnosis.
Although there appears to be a generally high level of agreement between diagnostic classification systems for those with no diagnosis or those evincing symptoms of a more severe condition, concordance between DSM-5 moderate and ICD-10 dependence diagnoses was poor. Additional research is warranted to determine the appropriateness and implications of the current DSM-5 coding guidelines regarding the assignment of an ICD-10 dependence code for those with a DSM-5 moderate diagnosis.
随着近期美国联邦政府要求所有美国医疗保健机构过渡到ICD - 10计费代码，需要实证证据来确定《精神疾病诊断与统计手册》第5版（DSM - 5）的诊断名称是否与其各自的ICD - 10诊断类别/计费代码相对应。本研究考察了DSM - 5与ICD - 10大麻使用障碍诊断之间的一致性。
数据来源于2000年至2003年最近被收押进一个州监狱系统的6871名男性和801名女性囚犯的常规临床评估。DSM - 5和ICD - 10的诊断判定是根据各自诊断公式的算法做出的。
在不同分类系统中，过去12个月大麻使用障碍的患病率相当。绝大多数没有DSM - 5诊断的囚犯按照ICD - 10仍然没有诊断，并且类似比例的患有DSM - 5重度诊断的囚犯获得了ICD - 10依赖诊断。诊断分类中的大多数差异是由那些患有DSM - 5中度诊断的人造成的，因为这些病例中约一半获得了ICD - 10依赖诊断，而其余病例获得了有害使用诊断。
虽然对于那些没有诊断或表现出更严重症状的人，诊断分类系统之间似乎普遍高度一致，但DSM - 5中度诊断与ICD - 10依赖诊断之间的一致性较差。有必要进行更多研究，以确定当前DSM - 5编码指南对于为患有DSM - 5中度诊断的人指定ICD - 10依赖代码的适当性和影响。
