Social Psychiatry and Psychiatric Epidemiology

, Volume 36, Issue 1, pp 45–51

DSM-IV and ICD-10 generalized anxiety disorder: discrepant diagnoses and associated disability

  • T. Slade
  • G. Andrews
ORIGINAL PAPER

DOI: 10.1007/s001270050289

Cite this article as:
Slade, T. & Andrews, G. Soc Psychiatry Psychiatr Epidemiol (2001) 36: 45. doi:10.1007/s001270050289

Abstract

Background: It is commonly assumed that diagnoses according to DSM-IV and ICD-10 are equivalent. Recent discussions on generalized anxiety disorder (GAD) have suggested that ICD-10 criteria may be identifying a milder form of the disorder than DSM-IV. This report examines prevalence and associated disability of DSM-IV and ICD-10 GAD. Methods: The Composite International Diagnostic Interview was administered to a community sample of 10,641 people, and the diagnostic criteria that contributed to discrepancies between DSM-IV and ICD-10 GAD were identified. A multiple linear regression analysis was carried out to determine the strength of the relationship between disability, as measured by the SF-12, and discrepant diagnoses of GAD. Results: The concordance between DSM-IV and ICD-10 GAD was fair (kappa=0.39). The two sources of discrepancy when DSM-IV was positive and ICD-10 was negative resulted from the requirement in ICD-10 that the respondent endorse symptoms of autonomic arousal (ICD-10 criterion B) and the requirement that ICD-10 GAD does not co-occur with panic/agoraphobia, social phobia or obsessive-compulsive disorder (ICD-10 criterion C). The two major sources of discrepancy when ICD-10 was positive and DSM-IV was negative resulted from the requirement in DSM-IV that the worry be excessive (DSM-IV criterion A) and that it causes clinically significant distress or impairment (DSM-IV criterion E). DSM-only GAD cases had significantly higher levels of disability than ICD-only cases of GAD after controlling for demographic variables and the presence of comorbid psychiatric disorders. Conclusions: While the prevalence rates for DSM-IV and ICD-10 GAD are almost identical, these classification systems are diagnosing different groups of people.

Copyright information

© Steinkopff Verlag 2001

Authors and Affiliations

  • T. Slade
    • 1
  • G. Andrews
    • 1
  1. 1.School of Psychiatry, University of New South Wales at St Vincent's Hospital, 299 Forbes Street, Darlinghurst, New South Wales, 2010 AustraliaAU
  2. 2.Clinical Research Unit for Anxiety Disorders, 299 Forbes Street, Darlinghurst NSW 2010, Australia e-mail: tims@crufad.unsw.edu.au Tel.: +61-2-93321013; Fax: +61-2-93324316AU