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Background: The diagnosis of paranoia/delusional disorder has been significantly modified and redefined from DSM-III to DSM-5, which in turn also meaningfully differ from the ICD-10 criteria. In this study we examined the degree to which these diagnostic systems differ on external variables.Method: Two-hundred and eighty-six subjects diagnosed of paranoia/delusional disorder according to DSM-III, DSM-III-R, DSM-IV, DSM-5 or ICD-10 criteria were examined for a number of validators including risk factors, premorbid features, illness-related variables and psychosocial functioning. The prevalence rates of the diagnostic criteria and their concordance level were examined, such as the degree to which the criteria sets and their main diagnostic features were differentially related to the validators.Results: Diagnostic criteria showed poor to fair concordance. The most inclusive system was the DSM-5 (n = 274) and the most restrictive the DSM-III (n = 187). Compared with subjects fulfilling other diagnostic criteria, those with a DSM-III diagnosis showed more and stronger associations with the validators: presence of cluster A personality disorders, insidious illness onset, poor response to treatment, chronic illness course and poor psychosocial functioning. This association pattern was mainly due to the 6-month duration criterion. Stability of delusions, type of delusions and the ICD-10 3-month duration criterion were poorly related to the validators.Conclusions: Diagnostic criteria for delusional disorder are not interchangeable. DSM-III criteria for paranoia may identify a more severe disorder mainly because the 6-month duration criterion. Type of delusions had a small impact on the validators across diagnostic systems. These findings have implications for future classifications of delusional disorder. [ABSTRACT FROM AUTHOR]

Objective:Bipolar disorder (BD) is common in clinical psychiatric practice, and several studies have estimated its prevalence to range from 0.5 to 5% in community-based samples. However, no systematic review and meta-analysis of the prevalence of BD type 1 and type 2 has been published in the literature. We carried out a systematic review and meta-analysis of the lifetime and 1-year prevalence of BD type 1 and type 2 and assessed whether the prevalence of BD changed according to the diagnostic criteria adopted (DSM-III, DSM-III-R vs. DSM-IV).Methods:We searched MEDLINE, Scopus, Web of Science, PsycINFO, and the reference lists of identified studies. The analyses included 25 population- or community-based studies and 276,221 participants.Results:The pooled lifetime prevalence of BD type 1 was 1.06% (95% confidence interval [95%CI] 0.81-1.31) and that of BD type 2 was 1.57% (95%CI 1.15-1.99). The pooled 1-year prevalence was 0.71% (95%CI 0.56-0.86) for BD type 1 and 0.50% (95%CI 0.35-0.64) for BD type 2. Subgroup analysis showed a significantly higher lifetime prevalence of BD type 1 according to the DSM-IV criteria compared to the DSM-III and DSM-IIIR criteria (p < 0.001).Conclusion:This meta-analysis confirms that estimates of BD type 1 and type 2 prevalence are low in the general population. The increase in prevalence from DSM-III and DSM-III-R to DSM-IV may reflect different factors, such as minor changes in diagnostic operationalization, use of different assessment instruments, or even a genuine increase in the prevalence of BD.

Copyright of Journal of International Social Research is the property of Journal of International Social Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The objective of this study was to describe the temperament dimension profiles assessed by the Temperament and Character Inventory (TCI) among young adults with the DSM-III-R personality disorder (PD). Our hypothesis was that PD clusters and separate PDs can be distinguished from one another by their specific temperament profiles. As a part of the 31-year follow-up survey of the prospective Northern Finland 1966 Birth Cohort, the cohort members living in the city of Oulu at the age of 31 years (n=1609) were invited to participate in a two-phase field study. The Structured Clinical Interview for DSM-III-R for PDs (SCID-II) was used as diagnostic instrument. The final study sample consisted of the 1311 subjects who had completed the Hopkins Symptom Check List-25 questionnaire for screening and had given a written informed consent. Of the 321 SCID interviewed subjects, 74 met the criteria for at least one PD and had completed the TCI. The mean TCI scores of subjects with PD and control subjects without PD (n=910) were compared. Low Novelty Seeking, high Harm Avoidance and low Reward Dependence characterized cluster A and C PDs. Subjects with a cluster B PD did not differ from controls, except for Novelty Seeking, which was high. The temperament dimensions could not distinguish different PDs very well, with the only exception of persons with obsessive-compulsive PD. PD clusters were associated with different profiles of temperament, lending some support for Cloninger's typology. [ABSTRACT FROM AUTHOR]

We assessed somatization symptoms and their associations among a 31-year-old Finnish population sample (n=1598). Data on somatization symptoms were gathered from a review of all medical public outpatient records. Subjects with four or more somatization symptoms according to the DSM-III-R criteria were classified as somatizers. Ninety-seven (83 females) DSM-III-R somatizers (6.1%) were found. Somatization associated with female sex, lower educational level and increased psychiatric morbidity. Roughly half of the somatizers had a comorbid psychiatric disorder. Mood disorders did not associate specifically with somatization - in fact, after adjusting for sex and educational level only anxiety disorders and personality disorders associated with somatization. It may be concluded that it is important to recognize psychiatric disorders in subjects with somatization symptoms, especially as these symptoms have been shown to be treatable with both psychotherapy and psychiatric medication. [ABSTRACT FROM AUTHOR]

This study served to replicate and extend the findings from the National Comorbidity Survey [Enns MW, Cox BJ, Clara I (2002) Psychol Med 32:997–1008], in examining associations between recalled parental bonding and the prevalence and incidence of mental disorders in adulthood. Data were used from 4,796 adults aged 18–64, who had participated in three waves (i.e., 1996, 1997, and 1999) of a large-scale Dutch epidemiological study. Parental lack of care and overprotection were significantly associated with both prevalence and incidence of DSM-III-R disorders. However, the impact of parental bonding was modest, explaining only 1–5% of the variance in the occurrence and onset of psychopathology. Chi-square tests demonstrated there were no differences between the impact of paternal and maternal rearing behaviors on mental disorders, or between lack of care and overprotection in the prediction of mental disorders. Overall, individuals’ recollections of parental lack of care and overprotection appear to be non-specifically, modestly related to the prevalence and incidence of DSM-III-R disorders in adults from the general population. Future research may examine indirect or mediated links between parental bonding and (clinical diagnoses of) mental health problems. [ABSTRACT FROM AUTHOR]

This longitudinal study investigated the scope and course of attention problems over a period of time from preteen (ages 7–12 years) to early teen years (ages 13–17 years). We compared symptoms in subjects with and without a family history (FH) of alcohol abuse or dependence from among families without evidence of antisocial personality disorder. Evaluations of attention problems for the offspring were based on the Child Behavior Checklist and a validated semistructured interview carried out with the mother. The findings indicate no higher risk for attention problems and attention-deficit hyperactivity disorder (ADHD)-like symptoms in the children of families with an alcohol use disorder. Regarding the course of problems, the ADHD symptom count tended to decrease over time, especially for children without a FH of alcohol abuse or dependence. Further research will be needed to determine whether results can be replicated with families from different social strata and including subjects with the antisocial personality disorder. Copyright © 2007 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background Recollections of cold and overprotective behaviors from parents have been hypothesized to lead to the presence of mental disorders in young adulthood through their detrimental effects on individuals' satisfaction in later partner relationships. Previous studies have not explicitly tested, however, whether partner relationship satisfaction mediates the longitudinal relationship from parental bonds to DSMIII- R disorders in young adults. Methods We examined: (1) whether recollections of parental bonds in the first 16 years of life were related to the prevalence of DSMIII- R mental disorders in young adulthood, and (2) whether young adults' satisfaction with current partner relationships mediated these links. Data were used from 1,581 Dutch young adults aged 18–34 years, who were interviewed in three waves (1996, 1997, and 1999) of a nationwide epidemiological study. Results Structural Equation Models demonstrated that recollections of caring, non-intrusive parenting behaviors were significantly, negatively associated with the prevalence of mood and anxiety disorders (but not substance disorders) in young adulthood. The satisfaction with current partner relationships did not mediate these negative associations. Conclusions Results replicate and extend earlier findings from the National Comorbidity Survey (Enns et al. 2002), demonstrating that mental disorders are directly related to people's recollections of parental care and overprotection. Low-quality parental bonds were only related to internalizing types of psychopathology, however, and were of a modest strength. Results may indicate that there is relatively little cross-relationship continuity in the experience of intimacy between relationships with parents and with partners. [ABSTRACT FROM AUTHOR]

Objective: To demonstrate the prevalence of social phobia and its relation to body image and self-esteem.Method: Study participants were 1003 students recruited from Cumhuriyet University as a randomized sample. Subjects were administered the Diagnostic Interview Schedule-III-Revised (DIS-III-R) Social Phobia Scale, the Rosenberg Self-Esteem Scale, and the Multidimensional Body-Self Relations Questionnaire (MBSRQ). We analyzed the data, using Fisher's exact chi-square test.Results: Lifetime prevalence of social phobia among university students was 9.6% and past-year prevalence was 7.9%. Self-esteem was lower (P < 0.05) among those with social phobia than among those without social phobia. Students with social phobia had lower scores on the MBSRQ than did those without social phobia (P < 0.0001).Conclusions: The results show that persons with social phobia have lower self-esteem and more distorted body image than do those without social phobia. [ABSTRACT FROM AUTHOR]

Somatization is a widespread problem in health care. We estimated the occurrence of Somatization Disorder (SD) using three different case-finding methods in a general population cohort. The sample consists of 1,598 subjects born in 1966. The case-finding methods according to the DSM-III-R criteria for SD were: 1) Finnish Hospital Discharge Register (FHDR) data, 2) analysis of the patient records in public outpatient care 1982-1997, and 3) Structured Clinical Interview for DSM-III-R (SCID) for 321 selected cases. The prevalence of SD was 1.1% (N = 18), giving a female-to-male ratio of 5:1. All cases were found among the public outpatient care records. No cases appeared in the FHDR or were recognized in the psychiatric interview. The lifetime prevalence of SD was comparable with previous western population studies. Methodologically, information from outpatient records may be more sensitive in detecting SD than hospital diagnosis or even psychiatric interview. Clinically we stress the importance of recognizing these cases by liaison psychiatrists especially because SD has been recognized as being difficult to treat among somatic and primary health service providers and because some promising treatment alternatives such as cognitive-behavioral therapy and antidepressants have emerged for SD patients. [Copyright &y& Elsevier]

: ObjectiveThe main aim of the present study is to establish the prevalence of eating disorders (ED) in adolescents of both genders. To our knowledge, such data have not previously been published using both DSM-IV and DSM-III-R criteria.: MethodThe study sample consisted of 1960 adolescents (1026 girls and 934 boys), 14–15 years of age. The participants completed the Survey for Eating Disorders (SEDs), including DSM-III-R and DSM-IV diagnoses for all subcategories of ED.: ResultsLifetime prevalence of any ED among girls was 17.9% anorexia nervosa (AN) 0.7%, bulimia nervosa (BN) 1.2%, binge eating disorder (BED) 1.5%, and EDs not otherwise specified (EDNOS) 14.6%. Corresponding numbers for boys for any ED is 6.5%, AN 0.2%, BN 0.4%, BED 0.9%, and EDNOS 5.0%.: DiscussionOur prevalence rates on AN, BN, and BED largely support previous school/community-based studies, while our figures on EDNOS were rather high. Generally, we found high numbers for boys with ED. [Copyright &y& Elsevier]

Background:. Relationship transitions have consistently been found to be associated with mental health in young adulthood, but previous studies have not demonstrated clearly whether such relationship transitions actually precede the development of mental health problems and have focused almost exclusively on subclinical levels of problem behavior. Methods:. Longitudinal associations between the incidence of mood, anxiety, and substance disorders (DSM-III-R) and relationship transitions during young adulthood were examined using data from 1,581 Dutch young adults aged 18–34, who participated in three waves (1996, 1997, and 1999) of a nationwide epidemiological survey. Results:. Concurrent 3-year longitudinal associations showed that the incidence of mood and substance disorders was linked to relationship stability and change (i. e., staying single, breaking up/divorcing), but more rigorous, prospective analyses demonstrated that only the incidence of substance disorders was associated with previous relationship developments. Earlier prevalence of mood disorders increased young adults’ likelihood of subsequently experiencing a break-up/divorce and lowered the likelihood of becoming a parent, but mood disorders were in turn predicted by previously experienced relationship difficulties. Conclusions:. Apart from the negative consequences of a break-up/divorce, having a relatively unattached relationship status (i. e., not stably cohabiting/married, not being a parent) may be an important factor in explaining the onset of substance disorders. Furthermore, results qualify the notion of de-selection in certain partner roles by mood disorders; mood disorders negatively affect individuals’ chances of staying with one’s partner, but are in turn dependent on earlier partner relationship quality. [ABSTRACT FROM AUTHOR]

The main purpose of the present study was to investigate the diagnostic concepts of taijin-kyofusho (TKS) and social phobia, by comparing the clinical diagnosis of TKS and the operational diagnosis of Diagnostic and Statistical Manual of Mental Disorders (3rd edition, revised; DSMIII-R). Three evaluators conducted semistructured interview for DSM-III-R (SCID axis I and II, the Japanese version) to 88 outpatients who visited Jikei University Daisan Hospital, Japan, over a period of 1 year, requesting Morita therapy. The patients were also independently diagnosed by three psychiatrists to identify TKS. A total of 65.8% of 38 cases of TKS were diagnosed as social phobia. Among the neurotic TKS cases, the percentage was high at 81.5%, while among the delusional TKS cases it was 27.3%. A total of 42.1% of the TKS cases were diagnosed as mood disorder; 60.5% of the TKS cases presented some axis II disorders, among which avoidant personality disorder was the most prevalent (31.6%). There was no significant difference between the neurotic and delusional subtypes of TKS, regarding comorbidity with axis I diagnoses. As for axis II diagnoses, delusional TKS patients had a higher rate of comorbidity with paranoid personality disorder, although they demonstrated very similar trends in comorbidity with all other personality disorders. In the diagnostic system of DSM-III-R, it is highly likely that the neurotic and delusional subtypes of TKS will be seen to correspond to different diagnostic categories. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to empirically and objectively clarify the diagnostic standing of Morita shinkeishitsu, the subject of Morita therapy, by comparing and contrasting it with the operational diagnosis of the Diagnostic and Statistical Manual of Mental Disorders (3rd edition, revised; DSM-III-R). Morita therapists' clinical diagnoses of 88 outpatients who requested Morita therapy were compared with the results of the independently conducted operational diagnoses (structured clinical interview for DSM (SCID) for DSM-III-R, the Japanese version). In view of the result of axis I diagnoses, Morita shinkeishitsu corresponds to anxiety disorders, although it is a complex that also embodies mood disorders, which were found in one-quarter of the cases, as well as personality disorders, which were found in half of the cases, especially cluster C (avoidant, obsessive-compulsive, and dependent personality disorders). Morita shinkeishitsu is almost equivalent to anxiety disorders (DSM-III-R, axis I), and is a complex, a part of which includes mood disorders and cluster C personality disorders. [ABSTRACT FROM AUTHOR]

The five-factor model of personality, which has been widely studied in personality psychology, has been hypothesized to have specific relevance for DSM-defined personality disorders. To evaluate hypothesized relationships of the five-factor model of personality to personality disorders, 144 patients with personality disorders (diagnosed via a structured interview) completed an inventory to assess the five-factor model. Results indicated that the majority of the personality disorders can be differentiated in theoretically predictable ways using the five-factor model of personality. However, while the personality disorders as a whole appear to be differentiable from normal personality functioning on the five factors, the patterns are quite similar across the disorders, a finding that may provide some insight into the general nature of personality pathology but may also suggest problems with discriminant validity. Third, it does not appear that considering disorders as special combinations of features (as might be expected in some categorical models) is more informative than considering them as the sum of certain features (as might be expected in a dimensional model). [ABSTRACT FROM PUBLISHER]

Copyright of Kind en Adolescent is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A multicenter study was carried out to investigate the prevalence of psychosocial stressors and psychiatric comorbidity in patients suffering from migraine without aura (MWO) according to the International Headache Society criteria. Two hundred four adult MWO outpatients underwent a structured psychiatric interview (CIDI-c) to determine the presence of anxiety, and mood and somatoform disorders according to DSM-III-R criteria. An ad hoc questionnaire was used to assess psychosocial stress events. Anxiety disorders were found in 39.2% of the sample, mood disorders occurred in 23.0% and somatoform disorders in 21.6%. Psychosocial stressors were identified in 22.5% of the migraineurs without any difference between patients with and without psychiatric comorbidity. No correlation was found between psychiatric comorbidity and migraine duration or frequency. When the migraine patients were compared with a homogeneous group of tension-type headache sufferers, a higher frequency of psychiatric comorbidity was found in the latter group (56.4% vs. 77.8%, p = 0.01). These data suggest that migraine as well as tension-type headache are associated with an increased vulnerability to psychiatric disorders. Whether this is related to a common genetic susceptibility or is the effect of a psychoneurobiological loop related to the stress response activation remains to be investigated. [ABSTRACT FROM AUTHOR]

A systematic sample of 78 suicide attempters (37 men and 41 women), of whom 83% were hospitalized, were interviewed according to SCID I and II and Axes III-V according to DSM-III-R. Mood disorders were most common (56%). Forty-four suicide attempters (56%) suffered from comorbid diagnoses on Axis I-II. Borderline personality disorder was more common among women then men (56% vs. 24%, respectively, p = 0.01). Axis III disorders were confirmed for 45%. Sixty-two percent of the suicide attempters had severe psychosocial stressors (Axis IV). When comparing subjects with only Axis I disorders to those with Axis I and II disorders, no difference with respect to psychosocial stressor grade was observed. Moreover, those with only Axis I disorders were not impaired in their adaptive functioning (Axis V) even if severe psychosocial stressors were present. In contrast, an association ( p = 0.02) was found between high stress and low functioning in patients with both Axis I and Axis II disorders. The data suggest that in clinical practice, beside evaluation of Axis I and Axis II disorders, also stressors and global functioning should be included in the assessment of suicide risk after attempted suicide. [ABSTRACT FROM AUTHOR]

A multicenter study was carried out in 10 Italian Headache Centers to investigate the prevalence of psychosocial stress and psychiatric disorders listed by the IHS classification as the "most likely causative factors" of tension-type headache (TTH). Two hundred and seventeen TTH adult outpatients consecutively recruited underwent a structured psychiatric interview (CIDI-c). The assessment of psychosocial stress events was carried out using an ad hoc questionnaire. The psychiatric disorders that we included in the three psychiatric items of the fourth digit of the IHS classification were depressive disorders for the item depression, anxiety disorders for the item anxiety, and somatoform disorders for the item headache as a delusion or an idea. Diagnoses were made according to DSM-III-R criteria. At least one psychosocial stress event or a psychiatric disorder was detected in 84.8% of the patients. Prevalence of psychiatric comorbidity was 52.5% for anxiety, 36.4% for depression, and 21.7% for headache as a delusion or an idea. Psychosocial stress was found in 29.5% of the patients and did not differ between patients with and without psychiatric comorbidity. Generalized anxiety disorder (83.3%) and dysthymia (45.6%) were the most frequent disorders within their respective psychiatric group. The high prevalence of psychiatric disorders observed in this wide sample of patients emphasizes the need for a systematic investigation of psychiatric comorbidity aimed at a more comprehensive and appropriate clinical management of TTH patients. [ABSTRACT FROM AUTHOR]

This study sought to determine the proportion of adult, male, heterosexual cross-dressers who acknowledge both gender dysphoria and at least occasional fetishistic response to cross-dressing. Subjects were 193 outpatients of the gender identity clinic or behavioral sexology department of a psychiatric teaching hospital. Questionnaire items were used to assess subjects' current level of gender dysphoria and their recent history of sexual response to cross-dressing. Subjects who reported higher levels of gender dysphoria tended to report lower frequencies of sexual arousal with cross-dressing (r = -.56, p < .0001) and lower frequencies of masturbation with cross-dressing (r = -.62, p < .0001). About half of even the most strongly gender dysphoric subjects, however, acknowledged that they still become sexually aroused or masturbate at least occasionally when cross-dressing. These findings indicate a need for revision in the DSM-III-R's diagnostic criteria for transvestism and gender identity disorders, which presuppose that gender dysphoria and fetishistic reactions are mutually exclusive. [ABSTRACT FROM AUTHOR]

- Eighty 13-15-year-old children who failed to attend one of four schools for more than 40% of a term, without good reason, were studied. A systematic schedule: (C.A.P.A.) was used in interviewing parents and children. Twenty-five had DSM-III-R Disruptive Behaviour Disorders and 15 had Anxiety/Mood Disorders. Truancy was associated with the former and school refusal with the latter but both often occurred without any Disorder. Fourteen children had neither school refusal nor truancy. Compared to controls, poor attenders came from materially disadvantaged homes. School refusal with anxiety disorders rarely received psychiatric treatment. Non-disturbed absentees were not usually dealt with appropriately. [ABSTRACT FROM AUTHOR]

This article describes the development and evaluation of the revised Ontario Child Health Study (OCHS) scales to measure conduct disorder, oppositional disorder, attention-deficit hyperactivity disorder, overanxious disorder, separation anxiety- and depression based on DSM-III-R symptom criteria. Problem checklist assessments were obtained from parents and teachers of children aged 6-16 and youths aged 12-16 drawn from: (1) a general population sample ( N= 1751); and (2) a mental health clinic sample ( N= 1027) in the tame industrialized, urban setting. Evaluation of the revised OCHS scales indicates that they possess adequate psychometric properties and provide an efficient means to obtain measurements of childhood psychiatric disorder, in general population studies, that correspond to DSM-III-R classification of disorder. [ABSTRACT FROM AUTHOR]

In 1994, DSM-IV will be published, with new criteria for alcohol abuse and dependence. Implications of the changes in criteria for alcohol use disorders were investigated by comparing the diagnoses made by the DSM-IV criteria and DSM-III-R criteria. The study was conducted in a sample of 424 patients in an inpatient alcohol rehabilitation unit in the New York metropolitan area. DSM-III-R and DSM-IV criteria showed similar results and high agreement for any alcohol use disorder (abuse and dependence combined). Alcohol dependence was also consistently diagnosed with DSM-III-R and DSM-IV criteria. Agreement between DSM-III-R and DSM-IV abuse diagnoses was very low. Compared with DSM-III-R, DSM-IV classified over three times as many patients as alcohol abusers, although those with alcohol dependence still overwhelmingly dominated the sample. With some fluctuations, the results were stable over Black, Hispanic, and White subgroups of patients. The direction of the findings was consistent with results from a national general population survey in that the prevalence of alcohol abuse increased in both studies. However, the clinical results alone would not have suggested the marked changes in relative prevalence of abuse and dependence that occurred in the general population when DSM-IV criteria were used in place of DSM-III-R. Research on diagnostic criteria limited to patient samples omits important information on the implications of changing aspects of the diagnostic criteria. The need for a coherent theory of alcohol abuse is highlighted. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare DSM-III-R and proposed formulations of DSM-IV diagnoses of alcohol use disorders in a clinical sample with the same assessment methods used in a large national survey previously reported. Issues included the number of symptoms required for abuse and dependence diagnoses, the effects of requiring evidence of physiological dependence to make the dependence diagnosis (Option 1 vs. Option 2), whether to require a duration criterion, and the concept of alcohol abuse. The diagnostic criteria proposed in the 1991 DSM-IV options book were the criteria investigated in this study. Concordance between DSM-III-R and DSM-IV was closest when the form of DSM-IV used was most similar to DSM-III-R. The duration criterion had much less effect on a dependence diagnosis in this clinical sample than in the general population. DSM-IV Option 2 for alcohol dependence excluded a number of cases from the dependence diagnosis who received such a diagnosis under DSM-III-R and DSM-IV Option 1. Abuse continued to function as a residual category, especially noticeable under increasingly restrictive definitions of dependence, and was rare in both the clinical and general population sample. Implications of the findings for research and other purposes are discussed. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to compare DSM-III-R and the proposed DSM-IV (options 1 and 2) diagnostic criteria for alcohol abuse and dependence in representative sample of the United States general population. Alcohol abuse and dependence diagnostic categories were contrasted in terms of prevalence and overlap. The prevalences of DSM-III-R and DSM-IV diagnoses of alcohol abuse and dependence combined were remarkably similar. However, disaggregation of abuse and dependence diagnoses showed that there were major discrepancies between the classification systems. Reasons for these discrepancies are discussed in terms of differences in the number of diagnostic criteria and the content of the DSM-III-R and DSM-IV abuse and dependence categories, the requirement for physiological dependence in DSM-IV classifications, the relationship between the abuse and dependence categories, and the impact of the duration criteria. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to compare DSM-III-R and the proposed DSM-IV diagnostic criteria for alcohol abuse and dependence in a representative sample of the United States general population. Alcohol abuse and dependence diagnostic categories were contrasted in terms of prevalence and overlap. The prevalence of DSM-III-R diagnoses of alcohol abuse and dependence combined (8.63%) was greater than the corresponding DSM-IV diagnoses (6.00%). Disaggregation of abuse and dependence diagnoses showed that the major discrepancy between the classification systems resided between the abuse categories. Reasons for the discrepancies are discussed in terms of differences in the content of the DSM-III-R and DSM-IV abuse categories, in the relationship that each abuse category shares with its respective dependence category, and the impact of the DSM-III-R duration criterion. [ABSTRACT FROM AUTHOR]

This article presents four exercises useful in facilitating family therapy education and supervision that offer a rapprochement between systems and individual conceptualizations, according to the DSM-III-R. The application of family systems models to individual psychopathology using these four exercises helps to bridge the gap between family systems and individual psychopathology. The exercises promote an understanding of the interlace between the individual and family system level and lead to more integrated conceptualizations of problems. They also suggest multiple routes of intervention. By integrating the family systems and individual approaches the benefits of the individual psychopathology approach can be retained without the potential negative side effects. The process of applying a family systems perspective to the DSM-III-R led to several conclusions about its use. The authors discovered that most of the limitations commonly associated with the DSM-III-R are not inherent in the taxonomic system itself, but in the use of the system. For example, users of the DSM-III-R may be apt to believe that it classifies people, when actually what are being classified are disorders that people have. There was nothing in the DSM-III-R that prohibited conceptualizing problems at an interactional level, viewing dysfunction as residing at the family level, limiting objectification of a client, or emphasizing the strengths of clients.

This study looks at the efficacy of brief focused cognitive-behavioural group intervention in the treatment of mood disorders in older adults in different diagnosis groups. At 1-year follow-up, out of a total of 27 patients, 70% required no input from the mental health services and also reported that they were ‘recovered’ and functioning well. When separated into two groups according to the diagnoses on DSM-III-R, 92% of the major depressive episode (MDE) group in contrast to 50% of the other disorders group were discharged and functioning well. This suggests that selection of patients using the DSM-III-R diagnostic method has helped to identify which depressed elderly people benefit most. A tentative link between personality difficulties is proposed as a possible obstacle to therapy. [ABSTRACT FROM AUTHOR]

This study examines the psychometric properties of two versions of the PTSD Sympton Scale (PSS). The scale contains 17 items that diagnose PTSD according to DSM-III-R criteria and assess the severity of PTSD symptoms. An interview and self-report version of the PSS were administered to a sample of 118 recent rape and non-sexual assault victims. The results indicate that both versions of the PSS have satisfactory internal consistency, high test-retest reliability, and good concurrent validity. The interview version yielded high inter- rater agreement when administered separately by two interviewers and excellent convergent validity with the SCID. When used to diagnose PTSD, the self-report version of the PSS was somewhat more conservative than the interview version. [ABSTRACT FROM AUTHOR]

This essay argues that making a diagnosis in medicine is essentially a hermeneutic enterprise, one in which interpretation skills play a major part in understanding a disease. The clinical encounter is an event comprised of two 'voices'; one is the voice of science which is grounded in empiricism, the other is that of human experience, which is grounded in story-telling and the interpretation of those stories. Using two 'voices', one from the Diagnostic and Statistical Manual of Mental Disorders-III-Revised, which describes 'alcohol abuse' and 'alcohol dependence', and the other, that of Claire, a character in Edward Albee's play, A Delicate Balance, who is conversing with her brother-in-law, Tobias, I apply principles from Hans-Georg Gadamer's hermeneutics to the clinical diagnostic process. The essay will demonstrate that we overlook an enormous amount of information about alcoholism by an overreliance on 'objective data' and that our hope for understanding alcoholics is in listening to their voices, and sharing the interpretation of their experiences with them. [ABSTRACT FROM AUTHOR]

Bij een groep van 170 kinderen die waren aangemeld bij een RIAGG werd onderzoek gedaan naar de samenhang tussen de Child Behavior Checklist (CBCL) en de DSM-III-R-classificatie. Een onderzoeker kreeg de opdracht om op basis van het door de ouders ingevulde gedragsprobleemgedeelte van de CBCL te komen tot de meest waarschijnlijke DSM-III-R-classificatie(s). Deze 'CBCL-classificatie' werd vergeleken met de DSM-III-R-classificatie die op basis van een uitgebreide intake was vastgesteld. Bij 65,4% van de kinderen bleken de CBCL- en intake-classificaties met elkaar overeen te komen (kappa = 0,62). [ABSTRACT FROM AUTHOR]

Copyright of Kind en Adolescent is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A case report of a male patient with moderate degree of learning disabilities and monosymptomatic hypochondriacal psychosis is described, along with its pathogenic features and response to treatment. [ABSTRACT FROM AUTHOR]

Diagnoses of alcohol dependence, using the classification systems ICD-9 and DSM-III-R, were compared in a sample of 215 psychiatric outpatients. A lower diagnostic threshold was obtained for DSM-III-R. This category tended to be more inclusive for relatively mild forms of inadequate alcohol use. Of those patients with ICD-9 alcohol dependence, 79% also met criteria for the corresponding DSM-III-R category, whereas 61% of subjects diagnosed as dependent according to DSM-III-R received the equivalent diagnosis in ICD-9. These results were obtained assuming equal base rates (sample frequencies) for dependence and abuse. Diagnoses were further compared with independently derived scores of the Munich Alcoholism Test (MALT), and the validity of DSM-III-R was found to be superior. Checklist-guided interviews had a positive impact upon accuracy and validity of diagnoses. [ABSTRACT FROM AUTHOR]

A 1-year follow-up study was carried out in 77 patients with panic attacks (panic disorder). Of these patients 43% were remitted; avoidance behaviour and chronic anxiety were more persistent than panic attacks within the 1-year period. The main predictor for features of anxiety in the follow-up was avoidance behaviour. The most prominent prognostic factor for features of depression was the history of previous depressive episodes. Female patients had a poorer outcome than male patients. [ABSTRACT FROM AUTHOR]

Contrasting the classification systems ICD-9 and DSM-III-R, a comparison of diagnoses for unipolar depressive disorders is presented from a sample of 168 psychiatric outpatients. A relatively clear correspondence existed between ICD-9 endogenous depression and DSM-III-R major depression. Neurotic depression (ICD-9) divided into either dysthymia or major depression in DSM-III-R. A generally greater variety of corresponding ICD-9 diagnoses was observed for DSM-III-R categories, since patients with eating disorders, alcohol or drug dependence, or with neuroses other than depressive type often received an additional specific DSM-III-R diagnosis for depression. For ICD-9 diagnostics, a decreased threshold was found for diagnosing depressive reaction, as compared with the equivalent DSM-III-R diagnosis of adjustment disorder with depressed mood. A new technique is introduced in order to adjust corresponding proportions according to base rate differences. [ABSTRACT FROM AUTHOR]

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The aim of the present study was to determine and assess a possible selection bias in an epidemiologic investigation in the elderly. A stratified sample of 1305 probands aged 60–99 years was initially contacted by mail and then by telephone to obtain their consent to participate in a psychiatric interview. A liberal recruitment procedure led to interview participation of only 291 subjects. The proportion of younger, male, and married subjects participating in the study was greater than that of elderly, female, and single or widowed subjects. Subjects without a psychiatric lifetime diagnosis were more cooperative than those with a psychiatric disorder. The latter finding demonstrates the need to determine and assess the selection bias in psychiatric epidemiologic studies in elderly subjects. [ABSTRACT FROM AUTHOR]

The long-term stability of subtypes of schizophrenic disorders in 148 narrowly defined schizophrenic patients according to four diagnostic systems was compared. The patients were investigated longitudinally for 23 years on average (range 10-50 years). Patients who experienced only one episode and those who were permanently hospitalised were excluded on methodological grounds. Of the remaining 100 patients, a total of 461 episodes were classified into various subtypes according to the criteria of DSM-III-R, ICD-10, the positive/negative dichotomy, and Schneider's first-rank symptoms. It was found that long-term stability of subtype in schizophrenic disorder was not the rule but the exception. The frequency of stable course was found to be depend on the type of the initial episode. In most cases a subtype change occurred within the first few years of the illness with no clear direction. In later stages of the illness the relative frequency of episodes predominated by negative symptomatology increased. The findings were similar for DSM-III-R, ICD-10 and positive/negative dichotomy. Only in patients beginning without first-rank symptoms were more stable than non-stable courses found. The results of this study do not support the assumption that stable subtypes are nosological or etiopathogenetic subentities of schizophrenic disorders. [ABSTRACT FROM AUTHOR]

The psychiatric classification systems ICD-10 and DSM-III-R were compared by applying both sets of diagnostic criteria to the same sample of patients suffering from affective and psychotic disorders. Four independent raters assessed diagnoses according to both systems to 100 written case records which had been prepared in a traditional, standard format. The International Diagnostic Checklists (IDCL) were employed to rate relevant psychopathological signs and symptoms and to apply diagnostic decision rules. The results showed that ICD-10 yielded a generally higher reliability for all main disorders except for bipolar disorder. Overall reliability was κ=0.53 for diagnoses according to DSM-III-R and 0.59 for diagnoses according to ICD-10. Agreement was best for affective disorders, moderate for schizophrenia and inacceptable for schizoaffective disorder. Insufficient boundaries were found in both systems between schizoaffective disorder on one side and schizophrenia and bipolar disorder on the other side. The different duration criteria for schizophrenia of six months in DSM-III-R and one month in ICD-10 tend to have considerable consequences for frequency rates of schizophrenia in a typical clinical setting. [ABSTRACT FROM AUTHOR]

Diagnostic checklists for the assessment of DSM-III-R Axis I diagnoses have proven to be a reliable and feasable instrument in research and routine clinical care. Therefore, a checklist for the assessment of the DSM-III-R Personality Disorders (MDCL-P) has been developed. An English version of the MDCL-P is available. The MDCL-P has been tested for reliability in a test-retest design. The average duration of the interview was 36 min. Of the patients, 48% received a diagnosis of at least one personality disorder. The Kappa value concerning the distinction personality disorder as opposed to no personality disorder was 0.62. The range of Kappa values of specific personality disorders, which were diagnosed at least five times, was from 0.35 to 0.79. [ABSTRACT FROM AUTHOR]

In the DSM-III and DSM-III-R the affective or mood category has been widened and moodincongruent psychotic affective illness (MICPAI) included. The present study was undertaken to determine whether this broad mood category is still homogeneous. Personality factors were used as parameters. Minnesota Multiphasic Personality Inventory findings of 54 patients with MICPAI were compared with those of 21 probands with a DSM-III typical affective disorder and with those of 15 DSM-III schizophrenics. It was shown that MICPAI differed significantly from typical affective disorder, but not from schizophrenia, in particular regarding the subscales 'schizophrenia' and 'psychopathic deviate'. When MICPAI was subdivided into the depressed and manic type, the depressed type was found to be more closely related to schizophrenia (with respect to the subscales 'paranoia' and 'schizophrenia'), whereas the manic type hardly differed from affective disorder. Whether this result is due to diagnostic inaccuracies is discussed. Our finding that MICPAI differs from typical affective disorder with respect to personality is in accordance with heredity and outcome studies demonstrating that MICPAI is associated with a higher risk for schizophrenia in firstdegree relatives and with worse outcomes when compared with typical affective disorder. It can thus be concluded that the decision to include MICPAI in the affective or mood category of the DSM-III or DSM-III-R has rendered this category more heterogeneous. [ABSTRACT FROM AUTHOR]

Thirty inpatients with somatoform disorders were examined with the structured clinical interview SCID for psychiatric lifetime diagnosis. In the present diagnoses, we found a concordance of 63% for somatoform and affective disorders and the lifetime comorbidity of both disorders was 87%. Additionally, patients with somatoform disorders frequently had a history of other psychiatric disorders (for example, anxiety disorders, 40%). For 73% of patients with somatoform disorders and a history of affective disorders, the onset of the somatoform disorder was prior to the onset of another psychiatric disorder. The time interval between the onsets of somatoform disorders and affective disorders was greater than 1 year for most patients; for 46% of the patients with a history of both disorders, the time interval between the two disorders was more than 5 years. The course of illness for somatoform and affective disorders was quite different; while affective disorders tended to episodic periods with interim remissions, the somatoform disorders usually showed long, chronic courses (mean duration of the current somatoform disorder was 11.9 years). Finally, the Symptom Check List SCL-90R demonstrated good discrimination between patients with affective and anxiety disorders. However, the SCL-90R failed to discriminate patients with somatoform disorders from affective- and anxiety-disordered subjects. Therefore, the development of other psychometric scales is necessary for the evaluation of patients with somatoform disorders. [ABSTRACT FROM AUTHOR]

All operationalized diagnostic systems contain a diagnostic category, which corresponds to the concept of major depression. Yet, these corresponding definitions are not identical. Up to now, no comprehensive comparisons of the competing diagnoses have been published. We will therefore present a series of studies, describing six different operational definitions of major depression according to their content and construction and empirically comparing them in large inpatient and outpatient samples. This first paper presents a descriptive comparison of the definitions given in the Feighner Diagnostic Criteria, the Research Diagnostic Criteria, the Diagnostic and Statistical Manual of Mental Disorders, third edition and third edition, revised, and in two developmental drafts of the ICD-10 diagnostic criteria for research (draft April 1987-187; draft April 1989-189). The descriptive comparison will demonstrate that there are many similarities, especially concerning the symptom-criteria of major depression. Classificatory relevance could only be assumed for those differences found for cut-offs, for time criteria and especially for exclusion criteria. Whether these differences are negligible and whether patients classified by different diagnostic systems are really comparable will be examined in subsequent publications. [ABSTRACT FROM AUTHOR]