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A comparison of DSM-III-R and ICD-10 personality disorder criteria in an out-patient population

Published online by Cambridge University Press:  09 July 2009

G. Sara ,
P. Raven  and
A. Mann
G. Sara
Affiliation:
Department of Psychiatry, Westmead Hospital, Westmead, NSW, Australia; Section of Metabolic Studies and Section of Epidemiology and General Practice, Institute of Psychiatry, London
P. Raven*
Affiliation:
Department of Psychiatry, Westmead Hospital, Westmead, NSW, Australia; Section of Metabolic Studies and Section of Epidemiology and General Practice, Institute of Psychiatry, London
A. Mann
Affiliation:
Department of Psychiatry, Westmead Hospital, Westmead, NSW, Australia; Section of Metabolic Studies and Section of Epidemiology and General Practice, Institute of Psychiatry, London
*
1Address for correspondence: Dr Peter Raven, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF.
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Synopsis

This study reports the results of a comparison of DSM-III-R and ICD-10 personality disorder criteria by application of both sets of criteria to the same group of patients. Despite the clinical relevance of these disorders and the need for reliable diagnostic criteria, such a comparison has not previously been reported. DSM-III-R and ICD-10 have converged in their classification of personality disorders, but some important differences between the two systems remain. Personality disorder diagnoses from both systems were obtained in 52 out-patients, using the Standardized Assessment of Personality (SAP), a brief, informant-based interview which yields diagnoses in both DSM-III-R and ICD-10. For individual personality disorder diagnoses, agreement between systems was limited. Thirty-four subjects received a personality disorder diagnosis that had an equivalent form in both systems, but only 10 subjects (29%) received the same primary diagnosis in each system. There was a difference in rate of diagnosis, with ICD-10 making significantly more personality disorder diagnoses. The lower diagnostic threshold of the ICD-10 contributed most of this effect. Further modifications in ICD-10 Diagnostic Criteria for Research (DCR) and DSM-IV to the personality disorder category have been considered. The omission in DSM-IV of three categories unique to that system and the raising of the threshold in ICD-10 DCR, do seem to have been helpful in promoting convergence.

Type
Original Articles
Information
Psychological Medicine , Volume 26 , Issue 1 , January 1996 , pp. 151 - 160
Copyright
Copyright © Cambridge University Press 1996

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