Rapaport M H, Tipp J E, Schuckit M A
Department of Psychiatry University of California, San Diego School of Medicine, La Jolla 92093-0603.
Am J Drug Alcohol Abuse. 1993;19(2):143-51. doi: 10.3109/00952999309002675.
As part of DSM-IV field trials for substance use disorders, 100 inpatients from two psychiatric substance abuse units were interviewed using a modified version of the Substance Abuse Module (SAM) to ascertain substance use diagnoses according to ICD-10 and DSM-III-R criteria. Both criteria sets developed from the theoretical framework presented by Gross and Edwards (1976) and thus, they should demonstrate close concurrence in diagnoses of dependence and abuse/harmful use. The kappa scores obtained in these analyses demonstrate good to excellent agreement on the diagnoses of dependence across substances. There was poor agreement between DSM-III-R and ICD-10 for abuse/harmful use diagnoses. Although there is generally good agreement between DSM-III-R and ICD-10 for substance dependence diagnoses, important differences exist between the two criteria sets both for the diagnoses of abuse and harmful use, and for the diagnosis of marijuana dependence. These differences are primarily due to the inclusion of social problems and repeated use of substances in hazardous situations as DSM-III-R criteria.
作为《精神疾病诊断与统计手册》第四版（DSM-IV）物质使用障碍现场试验的一部分，来自两个精神科物质滥用治疗单元的100名住院患者接受了使用物质滥用模块（SAM）修改版的访谈，以根据国际疾病分类第十版（ICD-10）和《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）标准确定物质使用诊断。这两个标准集均源自格罗斯和爱德华兹（1976年）提出的理论框架，因此，它们在依赖及滥用/有害使用的诊断中应显示出高度一致性。这些分析中获得的kappa分数表明，在各种物质的依赖诊断方面具有良好至极佳的一致性。在滥用/有害使用诊断方面，DSM-III-R与ICD-10之间的一致性较差。尽管DSM-III-R与ICD-10在物质依赖诊断方面总体上具有良好的一致性，但在滥用和有害使用的诊断以及大麻依赖的诊断方面，这两个标准集之间存在重要差异。这些差异主要是由于DSM-III-R标准纳入了社会问题以及在危险情况下反复使用物质。
