Rounsaville B J, Kosten T R, Williams J B, Spitzer R L
Am J Psychiatry. 1987 Mar;144(3):351-5. doi: 10.1176/ajp.144.3.351.
The authors field-tested proposed criteria for diagnoses of psychoactive substance use disorders in the revision of DSM-III (DSM-III-R) and compared them with DSM-III criteria in a treated group of 83 patients. They found a high level of agreement between the diagnostic systems in rates of diagnosis and in the individuals receiving the diagnosis. The greatest cross-system agreement occurred when the minimum number of symptoms required to make the DSM-III-R diagnosis was set at three. Discrepant diagnoses between systems related to removal of social consequences as a requirement for the DSM-III-R diagnoses, less emphasis on physiological tolerance in DSM-III-R, and disagreement in subjects with mild symptoms.
作者在《精神疾病诊断与统计手册》第三版修订版（DSM-III-R）中对精神活性物质使用障碍的诊断标准进行了现场测试，并将其与83例接受治疗患者的DSM-III标准进行了比较。他们发现，在诊断率和接受诊断的个体方面，这两种诊断系统之间的一致性很高。当将做出DSM-III-R诊断所需的最少症状数量设定为三个时，跨系统的一致性最高。不同诊断系统之间的差异诊断与将社会后果从DSM-III-R诊断要求中去除、DSM-III-R对生理耐受性的强调减少以及对轻度症状患者的诊断分歧有关。
