Depression, dysthymia and substance use disorders: sources of dissonance between ICD‐10 and DSM‐IV

Abstract The present study examined the diagnostic concordance between ICD‐10 and DSM‐IV in the depressive disorders, dysthymic disorder and substance dependence and substance harmful use/abuse disorder. The Composite International Diagnostic Interview (CIDI) was administered to 1504 people, in a sample derived from community and clinic cases, and discrepant diagnoses were identified for ICD‐10 and DSM‐IV. The diagnostic concordance for the depressive disorders, dysthymic disorder and substance dependence disorder was excellent (kappa = 0.89, 0.93, and 0.86, respectively). Diagnostic agreement in the substance harmful use/abuse disorder category was considerably lower (Kappa = 0.44). The small number of discrepancies in diagnoses of the depressive disorders, dysthymic disorder and substance dependence disorder are a reflection of minor but real differences in the diagnostic criteria. Discrepancies in the diagnosis of substance harmful use/abuse disorder are explained by different concepts proposed to define each disorder. Copyright © 1998 Whurr Publishers Ltd.